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Effective homocysteine-lowering vitamin B treatment in peritoneal dialysis patients.
Perit Dial Int 2004 Jul-Aug; 24(4):373-7PD

Abstract

BACKGROUND

Hyperhomocysteinemia, a risk factor for atherosclerosis, is frequently detected in patients with renal failure. Vitamin B supplementation reduces but rarely normalizes homocysteine (Hcy) levels in hemodialysis patients. There are no data about the effects of vitamin B therapy on Hcy levels in patients on peritoneal dialysis (PD).

AIMS

We performed this trial both to observe baseline plasma Hcy levels in PD patients and to assess the effects of vitamin B therapy on Hcy levels in continuous ambulatory PD patients.

METHODS

We conducted a 6-month prospective study of the effects of vitamin B therapy on plasma Hcy levels. Biochemical analyses were obtained at baseline and after every phase of treatment with folic acid, folic acid plus vitamin B12, and folic acid plus vitamin B12 plus vitamin B6. Eighteen of the 25 enrolled patients finished the study.

RESULTS

Hyperhomocysteinemia was present in 83% of PD patients. We detected a trend toward a significant inverse relationship between baseline Hcy and folate levels. There were no significant correlations between baseline Hcy and vitamin B12, peritoneal membrane permeability, dialytic efficiency, or computed peritoneal Hcy clearance. We obtained an effective decrease in mean Hcy concentration from 20 to 14.8 micromol/L after folic acid and vitamin B12 treatment. We observed a further reduction in mean Hcy level to 12.8 micromol/L using the triple therapy; 72% of patients normalized their Hcy value.

CONCLUSIONS

High doses of folic acid, vitamin B6, and vitamin B12 normalize Hcy values in the majority of PD patients. This treatment may be important in reducing cardiovascular morbidity and mortality.

Authors+Show Affiliations

Division of Nephrology and Dialysis, Vimercate Hospital, Vimercate, Italy. nediavim@libero.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

15335152

Citation

Righetti, Marco, et al. "Effective Homocysteine-lowering Vitamin B Treatment in Peritoneal Dialysis Patients." Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, vol. 24, no. 4, 2004, pp. 373-7.
Righetti M, Tommasi A, Lagona C, et al. Effective homocysteine-lowering vitamin B treatment in peritoneal dialysis patients. Perit Dial Int. 2004;24(4):373-7.
Righetti, M., Tommasi, A., Lagona, C., La Rosa, L., Uccellini, M., & Sessa, A. (2004). Effective homocysteine-lowering vitamin B treatment in peritoneal dialysis patients. Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis, 24(4), pp. 373-7.
Righetti M, et al. Effective Homocysteine-lowering Vitamin B Treatment in Peritoneal Dialysis Patients. Perit Dial Int. 2004;24(4):373-7. PubMed PMID: 15335152.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effective homocysteine-lowering vitamin B treatment in peritoneal dialysis patients. AU - Righetti,Marco, AU - Tommasi,Adalberto, AU - Lagona,Cinzia, AU - La Rosa,Lucia, AU - Uccellini,Mario, AU - Sessa,Adalberto, PY - 2004/9/1/pubmed PY - 2004/12/16/medline PY - 2004/9/1/entrez SP - 373 EP - 7 JF - Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis JO - Perit Dial Int VL - 24 IS - 4 N2 - BACKGROUND: Hyperhomocysteinemia, a risk factor for atherosclerosis, is frequently detected in patients with renal failure. Vitamin B supplementation reduces but rarely normalizes homocysteine (Hcy) levels in hemodialysis patients. There are no data about the effects of vitamin B therapy on Hcy levels in patients on peritoneal dialysis (PD). AIMS: We performed this trial both to observe baseline plasma Hcy levels in PD patients and to assess the effects of vitamin B therapy on Hcy levels in continuous ambulatory PD patients. METHODS: We conducted a 6-month prospective study of the effects of vitamin B therapy on plasma Hcy levels. Biochemical analyses were obtained at baseline and after every phase of treatment with folic acid, folic acid plus vitamin B12, and folic acid plus vitamin B12 plus vitamin B6. Eighteen of the 25 enrolled patients finished the study. RESULTS: Hyperhomocysteinemia was present in 83% of PD patients. We detected a trend toward a significant inverse relationship between baseline Hcy and folate levels. There were no significant correlations between baseline Hcy and vitamin B12, peritoneal membrane permeability, dialytic efficiency, or computed peritoneal Hcy clearance. We obtained an effective decrease in mean Hcy concentration from 20 to 14.8 micromol/L after folic acid and vitamin B12 treatment. We observed a further reduction in mean Hcy level to 12.8 micromol/L using the triple therapy; 72% of patients normalized their Hcy value. CONCLUSIONS: High doses of folic acid, vitamin B6, and vitamin B12 normalize Hcy values in the majority of PD patients. This treatment may be important in reducing cardiovascular morbidity and mortality. SN - 0896-8608 UR - https://www.unboundmedicine.com/medline/citation/15335152/Effective_homocysteine_lowering_vitamin_B_treatment_in_peritoneal_dialysis_patients_ L2 - http://www.pdiconnect.com/cgi/pmidlookup?view=long&pmid=15335152 DB - PRIME DP - Unbound Medicine ER -