The influence of estimated creatinine clearance on plasma homocysteine in hypertensive patients with normal serum creatinine

Objectives To examine the relation of estimated creatinine clearance (eCrCl) and plasma total homocysteine (tHcy) in hypertensive patients with a normal serum creatinine level. Design and methods A total of 137 hypertensive patients (mean age 66.6 years, 69 men) with serum creatinine level ≤ 1.5 mg/dL gave 10-h fasting blood samples for measurement of tHcy, serum folic acid, and serum vitamin B12. Results 95 patients fell into a chronic renal insufficiency (CRI) group (eCrCl ≤ 60 mL/min/1.73 m2) and 42 into a normal renal function (NRF) group (eCrCl > 60 mL/min/1.73 m2). The CRI group was older (p < 0.001), had higher tHcy (p < 0.001), higher serum urea nitrogen (p < 0.001), higher serum creatinine (p < 0.001), lower eCrCl (p < 0.001), and lower diastolic blood pressure (p = 0.001). In univariate analysis, eCrCl had the strongest correlation with tHcy (r = − 0.453, p < 0.001). Significant correlations, ranging in decreasing order from r = − 0.418, p < 0.001 to r = − 0.170, p = 0.047, were also noted between tHcy and twelve other variables. In multivariate analysis, only eCrCl (p < 0.001), usage of fibrate (p < 0.001), serum level of vitamin B12 (p = 0.002), serum level of folic acid (p = 0.009), and smoking (p = 0.027) were independent predictors of tHcy. Conclusion eCrCl is a strong independent predictor of tHcy in hypertensive patients with normal serum creatinine.