Abstract | BACKGROUND: METHODS: Two prospective studies were undertaken in hemodialysis patients. In the first study (protocol A), hyperhomocysteinemia was treated in 77 patients with 30 or 60 mg folic acid with or without vitamins B6 and B12 for eight weeks and compared with matching placebos. In the second study (protocol B), hyperhomocysteinemia was treated in 37 patients with intravenous folinic acid given alone or with serine and compared with matching placebos. All patients received the standard of care treatment with a multivitamin tablet before and throughout the protocol to test the hypothesis that additional therapy is required over and above the routine therapy for maximum reduction in total homocysteine (tHcy). RESULTS: Normal volunteers; The mean (SD) tHcy of 128 normal subjects was 6.5 (4) micromol/L. Protocol A; Plasma folate increased significantly in the groups given folic acid at both four and eight weeks (P = 0.0001 at both time points). Plasma vitamin B12 was significantly increased at four weeks (P = 0.0018) but not at eight weeks (P = 0.064) in those given Vitamin B12. However, tHcy did not differ between treatment groups at baseline (P = 0.63), four weeks (P = 0.79) or eight weeks (P = 0.74). Protocol B: Plasma folate increased significantly at four weeks in those receiving folinic acid (P = 0.0001) but tHcy was not significantly different between groups (P = 0.92). In neither study was there any significant change in tHcy comparing before and during any treatment intervention. CONCLUSIONS:
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Authors | Joyce M Gonin, Hien Nguyen, René Gonin, Avina Sarna, Anne Michels, Faye Masri-Imad, Geeta Bommareddy, Christophe Chassaing, Irving Wainer, Asif Loya, Douglas Cary, Lew F Barker, Ali Assefi, Robert Greenspan, David Mahoney, Christopher S Wilcox |
Journal | Journal of nephrology
(J Nephrol)
2003 Jul-Aug
Vol. 16
Issue 4
Pg. 522-34
ISSN: 1121-8428 [Print] Italy |
PMID | 14696754
(Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Serine
- Vitamin B 6
- Folic Acid
- Vitamin B 12
- Leucovorin
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Topics |
- Administration, Oral
- Adult
- Aged
- Aged, 80 and over
- Controlled Clinical Trials as Topic
- Dose-Response Relationship, Drug
- Drug Administration Schedule
- Drug Therapy, Combination
- Female
- Folic Acid
(administration & dosage)
- Follow-Up Studies
- Humans
- Hyperhomocysteinemia
(drug therapy, etiology)
- Infusions, Intravenous
- Kidney Failure, Chronic
(complications, diagnosis, therapy)
- Leucovorin
(administration & dosage)
- Male
- Middle Aged
- Prospective Studies
- Reference Values
- Renal Dialysis
(adverse effects, methods)
- Risk Assessment
- Serine
(administration & dosage)
- Severity of Illness Index
- Treatment Outcome
- Vitamin B 12
(administration & dosage)
- Vitamin B 6
(administration & dosage)
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