Abstract | BACKGROUND: METHODS: Ten haemodialysis patients with macrocytic anaemia due to dietary folic acid deficiency were compared to 10 matched (age, duration of dialysis, degree of anaemia) patients with normocytic normochromic anaemia. Nineteen patients received erythropoietin-alpha intravenously thrice weekly. The study design was a prospective crossover (ABA) comparison of the effects of intravenously administered high doses of folic acid on haemoglobin levels and EPO doses, with 6 months active supplementation (B) and two periods of 6 months duration each without folic acid supplementation (A). RESULTS: The two patient groups did not differ at recruitment. Red blood cell folate levels were normal in patients with normocytic anaemia, but they were subnormal in all patients with macrocytic anaemia. Compared to the first period without folic acid supplementation, patients with macrocytic anaemia had significantly higher haemoglobin levels despite lower EPO doses after 6 months high-dose folic acid, and red cells had become normocytic. The removal of folic acid supplementation resulted in re-occurrence of macrocytosis and in a significantly lower response to rHu-EPO. In contrast, high-dose folic acid supplementation had no effect on response to rHu-EPO in patients with normocytic anaemia. CONCLUSIONS:
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Authors | Helmut Schiffl, Susanne M Lang |
Journal | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
(Nephrol Dial Transplant)
Vol. 21
Issue 1
Pg. 133-7
(Jan 2006)
ISSN: 0931-0509 [Print] England |
PMID | 16144854
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Recombinant Proteins
- Erythropoietin
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Topics |
- Adult
- Aged
- Anemia, Macrocytic
(complications, diagnosis, drug therapy)
- Case-Control Studies
- Erythropoietin
(therapeutic use)
- Female
- Folic Acid Deficiency
(complications, diagnosis)
- Follow-Up Studies
- Hematopoiesis
(drug effects, physiology)
- Humans
- Kidney Failure, Chronic
(complications, diagnosis, therapy)
- Kidney Function Tests
- Male
- Middle Aged
- Probability
- Recombinant Proteins
- Reference Values
- Risk Assessment
- Severity of Illness Index
- Statistics, Nonparametric
- Treatment Outcome
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