23 April 2003
Effects of folic acid treatment on homocysteine levels and vascular disease in hemodialysis patients.
Marco Righetti, Gian Michele Ferrario, Silvana Milani, Paola Serbelloni, Lucia La Rosa, Mario Uccellini, Adalberto SessaMed Sci Monit 2003; 9(4): PI19-24 :: ID: 4688
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, B[sub]6[/sub] and B[sub]12[/sub] 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.
Keywords: Hyperhomocysteinemia - blood, Kidney Failure, Chronic - drug therapy, Survival Rate - trends
Editorial
01 March 2024 : Editorial
Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and Transfusion-Dependent β-ThalassemiaDOI: 10.12659/MSM.944204
Med Sci Monit 2024; 30:e944204
In Press
18 Mar 2024 : Clinical Research
Sexual Dysfunction in Women After Tibial Fracture: A Retrospective Comparative StudyMed Sci Monit In Press; DOI: 10.12659/MSM.944136
21 Feb 2024 : Clinical Research
Potential Value of HSP90α in Prognosis of Triple-Negative Breast CancerMed Sci Monit In Press; DOI: 10.12659/MSM.943049
22 Feb 2024 : Review article
Differentiation of Native Vertebral Osteomyelitis: A Comprehensive Review of Imaging Techniques and Future ...Med Sci Monit In Press; DOI: 10.12659/MSM.943168
23 Feb 2024 : Clinical Research
A Study of 60 Patients with Low Back Pain to Compare Outcomes Following Magnetotherapy, Ultrasound, Laser, ...Med Sci Monit In Press; DOI: 10.12659/MSM.943732
Most Viewed Current Articles
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952