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[Frequency of hyperhomocysteinemia in hemodialysis patients with folic acid supplementation].
Orv Hetil. 2002 Jul 07; 143(27):1635-40.OH

Abstract

BACKGROUND

It is known that hyperhomocystinemia is an independent risk factor for development of atherosclerosis. In end stage renal disease the frequency of hyperhomocystinemia is much greater than in normal populations.

AIM

In this study homocystein (Hcy), folic acid and vitamin B12 concentrations were determined in 125 chronic renal failure patients being on folic acid supplementation (3 mg/day). In 107 patients the frequency of C667T polymorphism of methylene tetrahyrofolate reductase (MTHFR) was also determined. The relationships between these parameters were also studied.

RESULTS

It was found that in these patients who are under continuous folic acid supplementation the mean level of homocysteine was 16.8 +/- 7.2 mumol/L, a value considerably lower than the homocysteine concentration reported for non-supplemented patients. The elevation of homocysteine concentrations was independent of gender, time spent in renal replacement therapy, and the type of renal replacement therapy (hemodialysis: 17.6 +/- 12.6; hemodiafiltration: 16.6 +/- 12.9 mumol/L). Data showed an inverse relation between plasma homocysteine concentrations and the concentrations of folic acid and vitamin B12. Moderately severe hyperhomocystinemia (Hcy > 20 mumol/L) was found in about 30% of patients. In those the frequency of patients for homozygous T677 allele of MTHFR was about 25-30%. However, in all ESRD patients the frequency of the homozygotes was the same then in the normal population. Homocysteine plasma levels correlated with MTHFR polymorphism: in the wild type group Hcy was 14 +/- 7 mumol/L, in the heterozygous group was 17.2 +/- 6.2 mumol/L, and in the homozygous group was 21 +/- 19 mumol/L.

CONCLUSIONS

Long-term folic acid supplementation decreased the homocysteine level in end stage renal disease patients. However, in folic acid resistant group, who were in 30% homozygotes for C667T of MTHFR (suggesting that homocysteine-methionine remethylation cycle is disturbed), instead of the administration of folic acid, methylene tetrahydrofolate supplementation might be considered.

Authors+Show Affiliations

Debreceni Egyetem Orvos- és Egészségtudományi Centrum, I. sz. Belgyógyászati Klinika. karpati@ibel.dote.huNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

hun

PubMed ID

12180000

Citation

Kárpáti, István, et al. "[Frequency of Hyperhomocysteinemia in Hemodialysis Patients With Folic Acid Supplementation]." Orvosi Hetilap, vol. 143, no. 27, 2002, pp. 1635-40.
Kárpáti I, Balla J, Szóke G, et al. [Frequency of hyperhomocysteinemia in hemodialysis patients with folic acid supplementation]. Orv Hetil. 2002;143(27):1635-40.
Kárpáti, I., Balla, J., Szóke, G., Bereczky, Z., Páll, D., Ben, T., Toma, K., Katona, E., Mohácsi, A., Paragh, G., Varga, Z., Kakuk, G., & Muszbek, L. (2002). [Frequency of hyperhomocysteinemia in hemodialysis patients with folic acid supplementation]. Orvosi Hetilap, 143(27), 1635-40.
Kárpáti I, et al. [Frequency of Hyperhomocysteinemia in Hemodialysis Patients With Folic Acid Supplementation]. Orv Hetil. 2002 Jul 7;143(27):1635-40. PubMed PMID: 12180000.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Frequency of hyperhomocysteinemia in hemodialysis patients with folic acid supplementation]. AU - Kárpáti,István, AU - Balla,József, AU - Szóke,Gabriella, AU - Bereczky,Zsuzsanna, AU - Páll,Dénes, AU - Ben,Thomas, AU - Toma,Kornél, AU - Katona,Evelin, AU - Mohácsi,Attila, AU - Paragh,György, AU - Varga,Zsuzsa, AU - Kakuk,György, AU - Muszbek,László, PY - 2002/8/16/pubmed PY - 2002/10/10/medline PY - 2002/8/16/entrez SP - 1635 EP - 40 JF - Orvosi hetilap JO - Orv Hetil VL - 143 IS - 27 N2 - BACKGROUND: It is known that hyperhomocystinemia is an independent risk factor for development of atherosclerosis. In end stage renal disease the frequency of hyperhomocystinemia is much greater than in normal populations. AIM: In this study homocystein (Hcy), folic acid and vitamin B12 concentrations were determined in 125 chronic renal failure patients being on folic acid supplementation (3 mg/day). In 107 patients the frequency of C667T polymorphism of methylene tetrahyrofolate reductase (MTHFR) was also determined. The relationships between these parameters were also studied. RESULTS: It was found that in these patients who are under continuous folic acid supplementation the mean level of homocysteine was 16.8 +/- 7.2 mumol/L, a value considerably lower than the homocysteine concentration reported for non-supplemented patients. The elevation of homocysteine concentrations was independent of gender, time spent in renal replacement therapy, and the type of renal replacement therapy (hemodialysis: 17.6 +/- 12.6; hemodiafiltration: 16.6 +/- 12.9 mumol/L). Data showed an inverse relation between plasma homocysteine concentrations and the concentrations of folic acid and vitamin B12. Moderately severe hyperhomocystinemia (Hcy > 20 mumol/L) was found in about 30% of patients. In those the frequency of patients for homozygous T677 allele of MTHFR was about 25-30%. However, in all ESRD patients the frequency of the homozygotes was the same then in the normal population. Homocysteine plasma levels correlated with MTHFR polymorphism: in the wild type group Hcy was 14 +/- 7 mumol/L, in the heterozygous group was 17.2 +/- 6.2 mumol/L, and in the homozygous group was 21 +/- 19 mumol/L. CONCLUSIONS: Long-term folic acid supplementation decreased the homocysteine level in end stage renal disease patients. However, in folic acid resistant group, who were in 30% homozygotes for C667T of MTHFR (suggesting that homocysteine-methionine remethylation cycle is disturbed), instead of the administration of folic acid, methylene tetrahydrofolate supplementation might be considered. SN - 0030-6002 UR - https://www.unboundmedicine.com/medline/citation/12180000/[Frequency_of_hyperhomocysteinemia_in_hemodialysis_patients_with_folic_acid_supplementation]_ L2 - https://medlineplus.gov/kidneyfailure.html DB - PRIME DP - Unbound Medicine ER -