Document Detail

Association between adherence to folic acid supplements and serum folate, and plasma homocysteine among hemodialysis patients.
MedLine Citation:
PMID:  20650653     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine the relationship between adherence to prescribed folic acid supplements and folic acid intake, serum folate and plasma homocysteine in hemodialysis patients. The effects of change in adherence patterns from enrollment to 1 year later on changes in these same measures were also assessed.
DESIGN: Secondary data analysis.
PARTICIPANTS: Eighty-six hemodialysis patients who participated in the Hemodialysis (HEMO) Study's Homocysteine ancillary study.
MAIN OUTCOME MEASURES: Folic acid supplement intake, serum folate, and plasma homocysteine.
RESULTS: Eighty-eight percent of patients at enrollment and 91% 1 year later were adherent to prescribed folic acid supplements. Nonadherers had lower intakes of folic acid at both enrollment and 1 year later and lower serum folate levels at enrollment. Percent change was significantly different between the 3 adherence change groups for folic acid intake (P = .001) and plasma homocysteine (P < .001) from enrollment to 1 year later. The nonadherent group at enrollment had the lowest intakes and serum folate levels, and the highest plasma homocysteine levels. When they became adherent 1 year later, they had the greatest change in folic acid intake (5,461%; P = .03), coupled with a 69% increase in serum folate (P = .04) and a 29% decrease in plasma homocysteine (P = .03).
CONCLUSIONS: Hemodialysis patients who were nonadherent to folic acid supplement prescriptions had low folic acid intakes, low serum folates, and high homocysteine levels. When their adherence improved, folic acid intakes rose, serum folates increased, and plasma homocysteine levels decreased, although mild hyperhomocysteinemia persisted.
June Leung; Johanna Dwyer; Patricia Hibberd; Paul Jacques; William Rand; Michael V Rocco;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2010-07-21
Journal Detail:
Title:  Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation     Volume:  21     ISSN:  1532-8503     ISO Abbreviation:  J Ren Nutr     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-25     Completed Date:  2011-08-11     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  9112938     Medline TA:  J Ren Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  246-56     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 National Kidney Foundation, Inc. All rights reserved.
Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts 02111, USA.
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MeSH Terms
Administration, Oral
Dietary Supplements*
Folic Acid / administration & dosage*,  blood*
Homocysteine / blood*
Hyperhomocysteinemia / therapy
Middle Aged
Multicenter Studies as Topic
Patient Compliance*
Randomized Controlled Trials as Topic
Renal Dialysis*
Vitamin B 12 / administration & dosage
Vitamin B 6 / administration & dosage
Grant Support
Reg. No./Substance:
454-28-4/Homocysteine; 59-30-3/Folic Acid; 68-19-9/Vitamin B 12; 8059-24-3/Vitamin B 6

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