So, Teddy’s on some new meds this trip (hey, we’re up to 10 meds in the morning, it’s very exciting.)

And you know me, I’m hitting Google this morning.

And I realize I am the ONLY person in the whole world who is going to find this fascinating, so feel free to skip this post.

One of his new meds is called Nephronex, it’s a B complex for renal patients. Check this out:

Homocysteine is formed when protein is broken down to be used by the body. People with chronic kidney disease (CKD) and ESRD have dangerously high levels of homocysteine in their blood. This is important because the kidneys play a role in ridding the body of excess homocysteine. When kidney function begins to decrease, homocysteine levels begin to climb. High levels of homocysteine in your blood can damage your vessels and increase the risk for heart attack and stroke.

Dialysis patients have two to four times higher homocysteine levels than the general population. Patients with ESRD have homocysteine levels of 20-30 micromoles per liter.

I have a genetic mutation called MTHFR. It makes it hard for the body to process folic acid and causes elevated homocystine levels. (It also has to do with the body’s process of breaking down protein, but it’s all complicated and uses big words and I won’t bore you with the details.) Some researchers believe there is a link between elevated homocystine and miscarriage (and, indeed, even in those with MTHFR mutations without elevated homocystine levels, there appears to be a link with miscarriage… they just haven’t pinned it down quite yet). MTHFR is also, because of the elevated homocystine, associated with heart disease, heart attack, stroke, and other goodies like that.

People who have variations in the MTHFR gene, especially the C677T variation, are more likely to have high-homocysteine levels. MTHFR gene variants have been correlated with increased miscarriage risk by some past studies, and the leading theory behind the association is that it is related to high-homocysteine levels in people with MTHFR gene variants.

For reference, normal homocystine is 5-15 micromoles/liter.


So, through two separate routes, my son and I have the same end problem. (however, I should note that my particular mutation is the A1298C variation, and it’s not as strongly correlated with high homocystine. Last time it was checked, my levels were slightly elevated, but not to a concerning point.

And just in case you were curious:

A high level of homocysteine in the blood has been connected to an increased risk of heart disease. It is the number one cause of death in ESRD.  According to the United States Renal Data System, Annual Data Report, nearly 50 percent of dialysis patients have atherosclerotic heart disease. Homocysteine is the most common heart disease risk factor in dialysis patients.  Is it possible that lowering homocysteine in the dialysis patient may reduce the risk of cardiovascular disease?

Scientists are conducting research to find out if lowering homocysteine will protect dialysis patients against heart disease. Because, nearly half of all dialysis patients have cardiovascular events, it is especially important for individuals with ESRD to have adequate levels of the three vitamins that lower homocysteine.

As a side note, I have found that there are two types of renal information websites. Those written for patients, and those written for medical people. (I mean, obviously, I guess.) The patient-centric ones tend to be “your doctor will prescribe the medicine you need. you just need to take it like a good little girl.” Highly annoying.


We’ve also switched him from a Calcium Channel Blocker (amlodapine) to an ACE inhibitor (enalapril)


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