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  lüll Mechanisms of homocysteine-induced glomerular injury and sclerosis Yi F; Li PLAm J Nephrol  2008[]; 28 (2): 254-64Hyperhomocysteinemia (hHcys) has been recognized as a critical risk or pathogenic  factor in the progression of end-stage renal disease (ESRD) and in the  development of cardiovascular complications related to ESRD. Recently, evidence  is accumulating that hHcys may directly act on glomerular cells to induce  glomerular dysfunction and consequent glomerular sclerosis, leading to ESRD. In  this review, we summarize recent findings that reveal the contribution of  homocysteine as a pathogenic factor to the development of glomerular sclerosis or  ESRD. In addition, we discuss several important mechanisms mediating the  pathogenic action of homocysteine in the glomeruli or in the kidney, such as  local oxidative stress, endoplasmic reticulum stress, homocysteinylation, and  hypomethylation. Understanding these mechanisms may help design new approaches to  develop therapeutic strategies for treatment of hHcys-associated end-organ damage  and for prevention of deterioration of kidney function and ultimate ESRD in  patients with hypertension and diabetes mellitus or even in aged people with  hHcys.|Animals[MESH]|Endoplasmic Reticulum/metabolism[MESH]|Homocysteine/*blood/metabolism[MESH]|Humans[MESH]|Kidney Diseases/blood/pathology[MESH]|Kidney Failure, Chronic/metabolism[MESH]|Kidney Glomerulus/*metabolism[MESH]|Kidney/injuries/*pathology[MESH]|Methylation[MESH]|Mitochondria/metabolism[MESH]|Models, Biological[MESH]|Oxidative Stress[MESH]|Oxygen/metabolism[MESH]|Reactive Oxygen Species[MESH]|Sclerosis/*pathology[MESH] |