Diabetes and chronic kidney disease are global health problems. Diabetic kidney disease (DKD) is the result of complex interactions between mechanisms such as hemodynamics, metabolism, oxidative stress, etc. Biomarkers of these mechanisms may have the potential to be biomarkers for estimating the future progression of DKD. Homocysteine (HCY) is a biomarker of oxidative stress, with a bidirectional interaction with both glycemic control and renal damage in patients with diabetic chronic kidney disease. Many studies have shown that HCY correlates with the level of renal damage, but there is still much debate about the correlation of HCY with the level of renal damage in the near future. Currently, there are no studies in Vietnam evaluating the relationship between baseline HCY levels and future renal damage in DKD patients. The objective of the study was to evaluate the correlation between baseline HCY and renal damage after 6 months in DKD patients.

This longitudinal study included 44 patients diagnosed with DKD each assessed at two visits separated by 6 months. Clinical characteristics and routine laboratory parameters were obtained from medical records. Serum HCY levels were quantitatively determined using the ADVIA centaur HCY assay and the ADVIA centaur XP immunoassay system. The 6-month measurement including: serum HCY2, HbA1c2, creatinine, cystatin C for estimate the Glomerular Filtration Rate (eGFR)2 and urine albumin/creatine rate (UACR)2. The differences in HbA1c, eGFR, UACR between the 6-month measurement and baseline were ∆ HbA1c, ∆eGFR, ∆UACR, respectively. This study was approved by the Ethics Committee (NO:1171/ĐHYD-HĐĐĐ; Date: November 23, 2023).

The correlation between HCY baseline and the 6-month after parameters were: Hba1c2 (r=-0.374, p=0.014), eGFRcre-cys2 (r=-0.479, p=0.001), and UACR2 (r=0.308, p=0.042). HCY baseline also corelated with ∆ HbA1c (r=-0.468, p=0.001), ∆eGFR (r=0.321, p=0.034), but not with ∆UACR (r=0.249, p=0.104).

Baseline HCY correlates with future kidney damage and the change of kidney damage in DKD patients. HCY has potential as a biomarker to predict the level of the change in kidney damage in DKD patients. Further long-term studies with larger sample sizes are needed to clarify the relationship between HCY and future kidney damage, as well as the role of HCY in predicting future outcomes for DKD patients.