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Efficacy of folate and vitamin B12 in lowering homocysteine concentrations in hemodialysis patients.

Abstract

To evaluate the efficacy of supplementation with high dose folic acid with and without vitamin B 12 in lowering plasma total homocysteine (tHcy) concentrations in hemodialysis (HD) patients, we studied 36 HD patients randomized into four groups according to the received therapeutic regimen: group I (only folic acid (FA), 5 mg/day), group II (FA, 5 mg/day + vitamin B 12 , 1 mg/day) group III (only FA, 15 mg/day), group IV (FA, 15 mg/day, vitamin B 12 , 1 mg/day) for a period of 8 weeks. Plasma tHcy and serum FA and vitamin B 12 levels were measured at baseline and after the supplementation period. Dietary intakes were assessed during the study period. At baseline, 27.8% of the patients had normal levels of tHcy and 72.2% had hyperhomocysteinemia. After supplementation, plasma tHcy increased by 1.35% in group I and decreased by 6.99%, 14.54% and 30.09% in groups II, III and IV respectively, which was only significant in group IV (P= 0.014). The patients did not show any significant changes in serum folic acid, but a significant change in serum vitamin B 12 in group IV (P= 0.006). Percentage of patients reaching normal levels of plasma tHcy was 5.6 fold higher in group IV than in the reference group (group I). No correlations were found between changes of plasma tHcy levels and dietary intakes. We conclude that oral supplementation with 15 mg/day folic acid together with 1 mg/day of vitamin B 12 is effective in reducing tHcy levels in HD patients. These supplements also have a desirable effect on serum folic acid and vitamin B12.

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  • Authors+Show Affiliations

    ,

    Department of Human Nutrition, National Nutrition and Food Technology Research Institute, Tehran, Iran. nassim_ab59@yahoo.com

    , , , ,

    Source

    MeSH

    Administration, Oral
    Adult
    Aged
    Biomarkers
    Dietary Supplements
    Double-Blind Method
    Drug Therapy, Combination
    Female
    Folic Acid
    Homocysteine
    Humans
    Hyperhomocysteinemia
    Male
    Middle Aged
    Nutritional Status
    Prospective Studies
    Renal Dialysis
    Treatment Outcome
    Vitamin B 12
    Vitamin B Complex

    Pub Type(s)

    Comparative Study
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    19736473

    Citation

    Azadibakhsh, Nassim, et al. "Efficacy of Folate and Vitamin B12 in Lowering Homocysteine Concentrations in Hemodialysis Patients." Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia, vol. 20, no. 5, 2009, pp. 779-88.
    Azadibakhsh N, Hosseini RS, Atabak S, et al. Efficacy of folate and vitamin B12 in lowering homocysteine concentrations in hemodialysis patients. Saudi J Kidney Dis Transpl. 2009;20(5):779-88.
    Azadibakhsh, N., Hosseini, R. S., Atabak, S., Nateghiyan, N., Golestan, B., & Rad, A. H. (2009). Efficacy of folate and vitamin B12 in lowering homocysteine concentrations in hemodialysis patients. Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 20(5), pp. 779-88.
    Azadibakhsh N, et al. Efficacy of Folate and Vitamin B12 in Lowering Homocysteine Concentrations in Hemodialysis Patients. Saudi J Kidney Dis Transpl. 2009;20(5):779-88. PubMed PMID: 19736473.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Efficacy of folate and vitamin B12 in lowering homocysteine concentrations in hemodialysis patients. AU - Azadibakhsh,Nassim, AU - Hosseini,Rahebeh Shaker, AU - Atabak,Shahnaz, AU - Nateghiyan,Navid, AU - Golestan,Banafsheh, AU - Rad,Anahita Hooshyar, PY - 2009/9/9/entrez PY - 2009/9/9/pubmed PY - 2009/12/16/medline SP - 779 EP - 88 JF - Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia JO - Saudi J Kidney Dis Transpl VL - 20 IS - 5 N2 - To evaluate the efficacy of supplementation with high dose folic acid with and without vitamin B 12 in lowering plasma total homocysteine (tHcy) concentrations in hemodialysis (HD) patients, we studied 36 HD patients randomized into four groups according to the received therapeutic regimen: group I (only folic acid (FA), 5 mg/day), group II (FA, 5 mg/day + vitamin B 12 , 1 mg/day) group III (only FA, 15 mg/day), group IV (FA, 15 mg/day, vitamin B 12 , 1 mg/day) for a period of 8 weeks. Plasma tHcy and serum FA and vitamin B 12 levels were measured at baseline and after the supplementation period. Dietary intakes were assessed during the study period. At baseline, 27.8% of the patients had normal levels of tHcy and 72.2% had hyperhomocysteinemia. After supplementation, plasma tHcy increased by 1.35% in group I and decreased by 6.99%, 14.54% and 30.09% in groups II, III and IV respectively, which was only significant in group IV (P= 0.014). The patients did not show any significant changes in serum folic acid, but a significant change in serum vitamin B 12 in group IV (P= 0.006). Percentage of patients reaching normal levels of plasma tHcy was 5.6 fold higher in group IV than in the reference group (group I). No correlations were found between changes of plasma tHcy levels and dietary intakes. We conclude that oral supplementation with 15 mg/day folic acid together with 1 mg/day of vitamin B 12 is effective in reducing tHcy levels in HD patients. These supplements also have a desirable effect on serum folic acid and vitamin B12. SN - 1319-2442 UR - https://www.unboundmedicine.com/medline/citation/19736473/Efficacy_of_folate_and_vitamin_B12_in_lowering_homocysteine_concentrations_in_hemodialysis_patients_ L2 - http://www.sjkdt.org/article.asp?issn=1319-2442;year=2009;volume=20;issue=5;spage=779;epage=788;aulast=Azadibakhsh DB - PRIME DP - Unbound Medicine ER -