Treatment with different doses of folic acid in haemodialysis patients: effects on folate distribution and aminothiol concentrations

2.50
Hdl Handle:
http://hdl.handle.net/2336/34672
Title:
Treatment with different doses of folic acid in haemodialysis patients: effects on folate distribution and aminothiol concentrations
Authors:
Arnadottir, M; Gudnason, V; Hultberg, B
Citation:
Nephrol. Dial. Transplant. 2000, 15(4):524-8
Issue Date:
1-Apr-2000
Abstract:
BACKGROUND: Hyperhomocysteinaemia is highly prevalent among haemodialysis patients and may contribute to their increased cardiovascular risk. Treatment with pharmacological doses of folic acid lowers the plasma homocysteine concentration in these patients. The purpose of the present study was to expand the knowledge about such treatment by testing the effects of stepwise increases in the dose of folic acid on the concentrations of plasma and red blood cell folate as well as the total plasma concentrations of homocysteine (tHcy), cysteine (tCys), and glutathione (tGSH) in patients on chronic hemodialysis. METHODS: Fourteen stable haemodialysis patients completed the study which consisted of four consecutive periods, each of 6 weeks duration: (i) no treatment with folic acid (control period); (ii) 5 mg of folic acid three times per week (15 mg/week); (iii) 5 mg of folic acid daily (35 mg/week); (iv) 10 mg of folic acid daily (70 mg/week). RESULTS: Neither plasma or red cell folate nor plasma aminothiol concentrations changed significantly during the control period. The mean red cell folate concentration doubled during the administration of folic acid at the dose of 15 mg/week but at higher doses the further rise was only marginal. The mean folate concentration in plasma increased steeply especially at the higher doses of folic acid. During treatment with 15 mg/week of folic acid, tHcy fell by a mean of 36%, tGSH increased by a mean of 34%, but tCys was unaffected. Increases in the dose of folic acid did not augment these responses. CONCLUSIONS: The maximal effect on tHcy seemed to be obtained already at the lowest given dose of folic acid (15 mg/week). At that dose, the red blood cells approached folate saturation, which may reflect the situation in other cells that participate in homocysteine metabolism and explain why further increases in the dose of folic acid are not effective from a tHcy-lowering point of view.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://ndt.oxfordjournals.org/cgi/content/abstract/15/4/524

Full metadata record

DC FieldValue Language
dc.contributor.authorArnadottir, M-
dc.contributor.authorGudnason, V-
dc.contributor.authorHultberg, B-
dc.date.accessioned2008-08-07T09:35:19Z-
dc.date.available2008-08-07T09:35:19Z-
dc.date.issued2000-04-01-
dc.date.submitted2008-08-07-
dc.identifier.citationNephrol. Dial. Transplant. 2000, 15(4):524-8en
dc.identifier.issn0931-0509-
dc.identifier.pmid10727548-
dc.identifier.doi10.1093/ndt/15.4.524-
dc.identifier.urihttp://hdl.handle.net/2336/34672-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractBACKGROUND: Hyperhomocysteinaemia is highly prevalent among haemodialysis patients and may contribute to their increased cardiovascular risk. Treatment with pharmacological doses of folic acid lowers the plasma homocysteine concentration in these patients. The purpose of the present study was to expand the knowledge about such treatment by testing the effects of stepwise increases in the dose of folic acid on the concentrations of plasma and red blood cell folate as well as the total plasma concentrations of homocysteine (tHcy), cysteine (tCys), and glutathione (tGSH) in patients on chronic hemodialysis. METHODS: Fourteen stable haemodialysis patients completed the study which consisted of four consecutive periods, each of 6 weeks duration: (i) no treatment with folic acid (control period); (ii) 5 mg of folic acid three times per week (15 mg/week); (iii) 5 mg of folic acid daily (35 mg/week); (iv) 10 mg of folic acid daily (70 mg/week). RESULTS: Neither plasma or red cell folate nor plasma aminothiol concentrations changed significantly during the control period. The mean red cell folate concentration doubled during the administration of folic acid at the dose of 15 mg/week but at higher doses the further rise was only marginal. The mean folate concentration in plasma increased steeply especially at the higher doses of folic acid. During treatment with 15 mg/week of folic acid, tHcy fell by a mean of 36%, tGSH increased by a mean of 34%, but tCys was unaffected. Increases in the dose of folic acid did not augment these responses. CONCLUSIONS: The maximal effect on tHcy seemed to be obtained already at the lowest given dose of folic acid (15 mg/week). At that dose, the red blood cells approached folate saturation, which may reflect the situation in other cells that participate in homocysteine metabolism and explain why further increases in the dose of folic acid are not effective from a tHcy-lowering point of view.en
dc.language.isoenen
dc.publisherOxford University Pressen
dc.relation.urlhttp://ndt.oxfordjournals.org/cgi/content/abstract/15/4/524en
dc.subject.meshBiological Markersen
dc.subject.meshCysteineen
dc.subject.meshDose-Response Relationship, Drugen
dc.subject.meshErythrocytesen
dc.subject.meshFemaleen
dc.subject.meshFolic Aciden
dc.subject.meshGlutathioneen
dc.subject.meshHematinicsen
dc.subject.meshHomocysteineen
dc.subject.meshHumansen
dc.subject.meshHyperhomocysteinemiaen
dc.subject.meshKidney Failureen
dc.subject.meshMaleen
dc.subject.meshMethylenetetrahydrofolate Reductase (NADPH2)en
dc.subject.meshMiddle Ageden
dc.subject.meshOxidoreductases Acting on CH-NH Group Donorsen
dc.subject.meshPoint Mutationen
dc.subject.meshPolymerase Chain Reactionen
dc.subject.meshPteroylpolyglutamic Acidsen
dc.subject.meshRenal Dialysisen
dc.subject.meshTreatment Outcomeen
dc.titleTreatment with different doses of folic acid in haemodialysis patients: effects on folate distribution and aminothiol concentrationsen
dc.typeArticleen
dc.contributor.departmentDepartment of Medicine, National University Hospital, Reykjavik, Icelandic Heart Association Heart Preventive Clinic, Reykjavik, Iceland.en
dc.identifier.journalNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Associationen

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