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Effects of folic acid treatment on homocysteine levels and vascular disease in hemodialysis patients.
Med Sci Monit 2003; 9(4):PI19-24MS

Abstract

BACKGROUND

Cardiovascular disease is the most important cause of morbidity and mortality in hemodialysis patients. These patients frequently have hyperhomocysteinemia, a putative risk factor for cardiovascular disease. Treatment with folate, B6 and B12 partially reduces hyperhomocysteinemia. We conducted a long-term study to evaluate whether 15 mg is more effective than 5 mg oral folic acid as a daily dosage to decrease hyperhomocysteinemia, and to assess whether homocysteine-lowering treatment reduces the risk of cardiovascular disease in hemodialysis patients.

MATERIAL/METHODS

In a 1-year prospective randomised trial, 81 chronic hemodialysis patients, matched for age, gender and dialytic age, were divided into three groups: 30 untreated patients, 26 patients receiving 5 mg per day, and 25 patients receiving 15 mg per day.

RESULTS

There was a significant reduction in hyperhomocysteinemia over time in treated patients as compared to untreated, but there were no significant differences between the two treated groups. Only 12% of the treated patients reached normal total homocysteine plasma levels. We observed a trend towards a significant difference in survival rate in cardiovascular morbidity between treated and untreated patients. Furthermore, hemodialysis patients with new vascular events showed higher homocysteine levels than patients without events.

CONCLUSIONS

High-dose folic acid treatment did not improve outcome in hyperhomocysteinemia, and 88% of treated patients maintained higher than normal homocysteine levels. There was a trend towards a decreased rate of cardiovascular events in treated participants as compared to untreated ones.

Authors+Show Affiliations

Division of Nephrology and Dialysis, Vimercate Hospital, Vimercate, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

12709680

Citation

Righetti, Marco, et al. "Effects of Folic Acid Treatment On Homocysteine Levels and Vascular Disease in Hemodialysis Patients." Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, vol. 9, no. 4, 2003, pp. PI19-24.
Righetti M, Ferrario GM, Milani S, et al. Effects of folic acid treatment on homocysteine levels and vascular disease in hemodialysis patients. Med Sci Monit. 2003;9(4):PI19-24.
Righetti, M., Ferrario, G. M., Milani, S., Serbelloni, P., La Rosa, L., Uccellini, M., & Sessa, A. (2003). Effects of folic acid treatment on homocysteine levels and vascular disease in hemodialysis patients. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, 9(4), pp. PI19-24.
Righetti M, et al. Effects of Folic Acid Treatment On Homocysteine Levels and Vascular Disease in Hemodialysis Patients. Med Sci Monit. 2003;9(4):PI19-24. PubMed PMID: 12709680.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of folic acid treatment on homocysteine levels and vascular disease in hemodialysis patients. AU - Righetti,Marco, AU - Ferrario,Gian M, AU - Milani,Silvana, AU - Serbelloni,Paola, AU - La Rosa,Lucia, AU - Uccellini,Mario, AU - Sessa,Adalberto, PY - 2003/4/24/pubmed PY - 2003/8/2/medline PY - 2003/4/24/entrez SP - PI19 EP - 24 JF - Medical science monitor : international medical journal of experimental and clinical research JO - Med. Sci. Monit. VL - 9 IS - 4 N2 - BACKGROUND: Cardiovascular disease is the most important cause of morbidity and mortality in hemodialysis patients. These patients frequently have hyperhomocysteinemia, a putative risk factor for cardiovascular disease. Treatment with folate, B6 and B12 partially reduces hyperhomocysteinemia. We conducted a long-term study to evaluate whether 15 mg is more effective than 5 mg oral folic acid as a daily dosage to decrease hyperhomocysteinemia, and to assess whether homocysteine-lowering treatment reduces the risk of cardiovascular disease in hemodialysis patients. MATERIAL/METHODS: In a 1-year prospective randomised trial, 81 chronic hemodialysis patients, matched for age, gender and dialytic age, were divided into three groups: 30 untreated patients, 26 patients receiving 5 mg per day, and 25 patients receiving 15 mg per day. RESULTS: There was a significant reduction in hyperhomocysteinemia over time in treated patients as compared to untreated, but there were no significant differences between the two treated groups. Only 12% of the treated patients reached normal total homocysteine plasma levels. We observed a trend towards a significant difference in survival rate in cardiovascular morbidity between treated and untreated patients. Furthermore, hemodialysis patients with new vascular events showed higher homocysteine levels than patients without events. CONCLUSIONS: High-dose folic acid treatment did not improve outcome in hyperhomocysteinemia, and 88% of treated patients maintained higher than normal homocysteine levels. There was a trend towards a decreased rate of cardiovascular events in treated participants as compared to untreated ones. SN - 1234-1010 UR - https://www.unboundmedicine.com/medline/citation/12709680/Effects_of_folic_acid_treatment_on_homocysteine_levels_and_vascular_disease_in_hemodialysis_patients_ L2 - https://www.medscimonit.com/download/index/idArt/4688 DB - PRIME DP - Unbound Medicine ER -