Vascular Disease in Renal Transplant Patients

Reginald Gohh, MD with renal fellow Kamlesh Patel, MD
Principal investigators:
Reginald Gohh, MD
with renal fellow
Kamlesh Patel, MD

Hyperhomocysteinemia in either the fasting or post-methionine loading (PML) state is an independent risk factor for vascular disease in general populations. Stable renal transplant recipients experience an exceedingly high incidence of vascular disease events relative to general populations free of renal disease, even after adjustment for the presence of the traditional arteriosclerotic risk factors.

We have recently demonstrated that there is an excess prevalence of both fasting and PML hyperhomocysteinemia among stable transplant recipients versus appropriately matched controls. Hyperhomocysteinemia may, therefore, contribute to the increased incidence of vascular disease outcomes in these patients.

Our initial studies of transplant recipients also indicated that the major determinants of homocysteine metabolism, folate, vitamin B12 and B6 plasma status, are markedly deficient and that dietary supplementation with these nutrients can improve the homocysteine status in renal transplant recipients. In the future, we plan to expand our studies of vascular disease in the transplant population.