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Response of hyperhomocysteinemia to folic acid supplementation in patients with end-stage renal disease.
Clin Nephrol 1999; 51(2):108-15CN

Abstract

BACKGROUND

Elevated concentrations of homocysteine are associated with an increased risk for cardiovascular disease. Reasons for elevated homocysteine concentrations are folate or vitamin B12 deficiency, renal disease or genetic abnormalities. A high prevalence of hyperhomocysteinemia is found in patients with end-stage renal disease (ESRD). Since these patients are also at increased risk for vitamin deficiency, a supplementation study comparing two doses of folic acid was performed in patients with ESRD treated with maintenance hemodialysis or with peritoneal dialysis.

PATIENTS AND METHODS

Patients undergoing hemodialysis (n = 70) or peritoneal dialysis (n = 12) were supplemented with 2.5 mg or 5 mg folic acid (three times per week after each dialysis treatment) for four weeks in a parallel study design. In 20 hemodialysis patients, the effect of folic acid withdrawal was observed after four weeks.

RESULTS

Both supplementation schemes reduced homocysteine to a similar extent (35%) but did not normalize homocysteine concentrations in the majority of patients. Dialysis also had a strong homocysteine lowering effect. After supplementation, 74% of the hemodialysis patients had post-dialysis homocysteine concentrations within the reference range (<16 micromol/l). Homocysteine concentrations remained decreased in 20 patients four weeks after withdrawal of folic acid supplementation.

CONCLUSIONS

It is concluded that supplementation with 2.5 or 5 mg folic acid has a similar effect on homocysteine concentrations to supplementation regimens using 15 mg folic acid supplements. In contrast to the effect of folic acid supplementation in subjects with normal renal function, folic acid supplementation does not normalize homocysteine concentrations in ESRD patients.

Authors+Show Affiliations

Institute of Clinical Chemistry, University Hospital, Magdeburg, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10069646

Citation

Dierkes, J, et al. "Response of Hyperhomocysteinemia to Folic Acid Supplementation in Patients With End-stage Renal Disease." Clinical Nephrology, vol. 51, no. 2, 1999, pp. 108-15.
Dierkes J, Domröse U, Ambrosch A, et al. Response of hyperhomocysteinemia to folic acid supplementation in patients with end-stage renal disease. Clin Nephrol. 1999;51(2):108-15.
Dierkes, J., Domröse, U., Ambrosch, A., Bosselmann, H. P., Neumann, K. H., & Luley, C. (1999). Response of hyperhomocysteinemia to folic acid supplementation in patients with end-stage renal disease. Clinical Nephrology, 51(2), pp. 108-15.
Dierkes J, et al. Response of Hyperhomocysteinemia to Folic Acid Supplementation in Patients With End-stage Renal Disease. Clin Nephrol. 1999;51(2):108-15. PubMed PMID: 10069646.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Response of hyperhomocysteinemia to folic acid supplementation in patients with end-stage renal disease. AU - Dierkes,J, AU - Domröse,U, AU - Ambrosch,A, AU - Bosselmann,H P, AU - Neumann,K H, AU - Luley,C, PY - 1999/3/9/pubmed PY - 1999/3/9/medline PY - 1999/3/9/entrez SP - 108 EP - 15 JF - Clinical nephrology JO - Clin. Nephrol. VL - 51 IS - 2 N2 - BACKGROUND: Elevated concentrations of homocysteine are associated with an increased risk for cardiovascular disease. Reasons for elevated homocysteine concentrations are folate or vitamin B12 deficiency, renal disease or genetic abnormalities. A high prevalence of hyperhomocysteinemia is found in patients with end-stage renal disease (ESRD). Since these patients are also at increased risk for vitamin deficiency, a supplementation study comparing two doses of folic acid was performed in patients with ESRD treated with maintenance hemodialysis or with peritoneal dialysis. PATIENTS AND METHODS: Patients undergoing hemodialysis (n = 70) or peritoneal dialysis (n = 12) were supplemented with 2.5 mg or 5 mg folic acid (three times per week after each dialysis treatment) for four weeks in a parallel study design. In 20 hemodialysis patients, the effect of folic acid withdrawal was observed after four weeks. RESULTS: Both supplementation schemes reduced homocysteine to a similar extent (35%) but did not normalize homocysteine concentrations in the majority of patients. Dialysis also had a strong homocysteine lowering effect. After supplementation, 74% of the hemodialysis patients had post-dialysis homocysteine concentrations within the reference range (<16 micromol/l). Homocysteine concentrations remained decreased in 20 patients four weeks after withdrawal of folic acid supplementation. CONCLUSIONS: It is concluded that supplementation with 2.5 or 5 mg folic acid has a similar effect on homocysteine concentrations to supplementation regimens using 15 mg folic acid supplements. In contrast to the effect of folic acid supplementation in subjects with normal renal function, folic acid supplementation does not normalize homocysteine concentrations in ESRD patients. SN - 0301-0430 UR - https://www.unboundmedicine.com/medline/citation/10069646/Response_of_hyperhomocysteinemia_to_folic_acid_supplementation_in_patients_with_end_stage_renal_disease_ L2 - https://medlineplus.gov/kidneyfailure.html DB - PRIME DP - Unbound Medicine ER -