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- Title
Hyperhomocysteinemia in hemodialysis patients: Effects of 12-month supplementation with hydrosoluble vitamins.
- Authors
Tremblay, Richard; Bonnardeaux, Alain; Geadah, David; Busque, Lambert; Lebrun, Michel; Ouimet, Denis; Leblanc, Martine
- Abstract
Hyperhomocysteinemia in hemodialysis patients: Effects of 12-month supplementation with hydrosoluble vitamins. Background. High-efficiency hemodialysis may induce a deficiency in hydrosoluble vitamins. Supplementation with B-complex vitamins has been shown to lower serum homocysteine concentrations in several groups, but relatively few studies have concerned hemodialysis patients. Our objectives were to determine the status in B-complex vitamins in a large cohort of unsupplemented hemodialysis patients and to assess the effects of supplementation with hydrosoluble vitamins on serum homocysteine over one year. Methods. Serum total homocysteine (tHcy), vitamin B12 , folate, pyridoxal-5′-phosphate (P-5′-P; the active moiety of vitamin B6 ), as well as red blood cell folate concentrations, were measured in 168 chronic dialysis patients on three times weekly high-efficiency hemodialysis and not supplemented with hydrosoluble vitamins. Their methylenetetrahydrofolate reductase C677T (MTHFR) genotypes were also determined (homozygotes TT, heterozygotes CT, without mutation CC). All involved patients were then supplemented with hydrosoluble vitamins (once daily by mouth, DiaVite®; R&D Laboratories, Minneapolis, MN, USA), and half of them were randomized to receive in addition 10 mg intravenously of folic acid posthemodialysis (30 mg intravenously per week). Serum tHcy was monitored after 6 and 12 months of supplementation in the 140 and 128 patients available for follow-up. Results. At baseline, serum and red blood cell folate concentrations were within normal limits in all patients except for two with borderline serum folate (mean values of 21 ± 8 and 1195 ± 454 nmol/L), whereas serum vitamin B12 and P-5′-P were below normal in 11 and 65 patients, respectively (mean values of 327 ± 215 pmol/L and 19 ± 16 nmol/L for the 168 patients). Initial tHcy levels were increased in all patients...
- Subjects
VITAMINS; HEMODIALYSIS patients; PHYSIOLOGY
- Publication
Kidney International, 2000, Vol 58, Issue 2, p851
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1046/j.1523-1755.2000.00234.x