Different Doses of Oral Folic Acid for Homocysteine-Lowering Therapy in Patients on Hemodialysis: A Randomized Controlled Trial

Authors

  • Shahrzad Ossareh Division of Nephrology, Department of Medicine, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran Author
  • Hossein Shayan-Moghaddam Division of Nephrology, Department of Medicine, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran Author
  • Ashraf Salimi Division of Nephrology, Department of Medicine, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran Author
  • Mojgan Asgari Department of Pathology, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, IRAN Author
  • Farhat Farrokhi Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Author

Abstract

Introduction. We compared the effect of higher and lower doses of folic acid compared to our routine daily dose on plasma homocysteine levels, in our hemodialysis patients.

Materials and Methods. Eighty patients on hemodialysis receiving oral folic acid, 10 mg/d, were randomized to receive folic acid at either doses of 5 mg/d (group 1) or 15 mg/d (group 2) for 2 months. Plasma levels of total homocysteine were measured before and after the study period.

Results. Hyperhomocysteinemia was seen in 75 patients (93.8%) before, and in 37 patients of group 1 (92.5%) and 39 of group 2 (97.5%) after the study period. In group 1, a nonsignificant decrease occurred in plasma homocysteine level (29.67 ± 12.26 ?mol/L to 27.78 ± 9.94 ?mol/L, P = .30), while in group 2, there was a significant decrease in homocysteine level (32.40 ± 9.76 ?mol/L to 29.58 ± 9.62 ?mol/L, P = .01). Changes in homocysteine level correlated with its baseline level (r = -0.42, P < .001). In both groups, significant reductions in homocysteine level were seen mostly in those patients with high baseline homocysteines.

Conclusions. Routine folic acid supplementation of 10 mg/d could not normalize plasma homocysteine levels in most of our patients. Increasing folic acid dose made a statistically significant but clinically trivial decrease in homocysteine levels, and could not normalize homocysteine level in most patients. Patients with a higher baseline homocysteine level achieved a greater reduction, which may be explained by primary noncompliance of some patient. Further investigation of folic acid dosage is suggested.

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Published

2009-10-12

Issue

Section

ORIGINAL | Dialysis

How to Cite

Different Doses of Oral Folic Acid for Homocysteine-Lowering Therapy in Patients on Hemodialysis: A Randomized Controlled Trial. (2009). Iranian Journal of Kidney Diseases, 3(4), 227-233. https://www.ijkd.org/index.php/ijkd/article/view/208

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