High dose-B-vitamin treatment of hyperhomocysteinemia in dialysis patients.

Abstract:

:Hyperhomocysteinemia, an arteriosclerotic risk factor, persists in 75% of dialysis patients despite routine low dose supplementation with the B-vitamin co-factors/substrates for homocysteine (Hcy) metabolism, and normal or supernormal plasma status of these vitamins (Atherosclerosis 114:93, 1995). We conducted a placebo-controlled eight-week trial of the effect on plasma homocysteine of adding supraphysiologic dose folic acid (15 mg/day), B-6 (100 mg/day), and B-12 (1 mg/day) to the usual daily dosing of 1 mg folic acid, 10 mg B-6, and 12 micrograms B-12, in 27 hyperhomocysteinemic dialysis patients. Total plasma homocysteine was measured at baseline, and after four and eight weeks. Blinded analyses revealed no evidence of toxicity in the group randomized to supraphysiologic dose B-vitamin supplementation. Plasma homocysteine was significantly reduced after both four weeks (-29.8% vs. -2.0%; P = 0.0024) and eight weeks (-25.8% vs. +0.6%; P = 0.0009) of active versus placebo treatment. Also, 5 of 15 treated versus 0 of 12 placebo group patients had their plasma Hcy reduced to within the normative range (< 15 mumol/liter). Supraphysiologic doses of B-vitamins may be required to correct hyperhomocysteinemia in dialysis patients.

journal_name

Kidney Int

journal_title

Kidney international

authors

Bostom AG,Shemin D,Lapane KL,Hume AL,Yoburn D,Nadeau MR,Bendich A,Selhub J,Rosenberg IH

doi

10.1038/ki.1996.19

subject

Has Abstract

pub_date

1996-01-01 00:00:00

pages

147-52

issue

1

eissn

0085-2538

issn

1523-1755

pii

S0085-2538(15)59304-6

journal_volume

49

pub_type

临床试验,杂志文章,多中心研究,随机对照试验
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