Document Detail


Efficacy of folinic versus folic acid for the correction of hyperhomocysteinemia in hemodialysis patients.
MedLine Citation:
PMID:  11273876     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effectiveness of intravenous folinic acid or intravenous folic acid for the treatment of hyperhomocysteinemia of hemodialysis patients is unknown. In a randomized, controlled, double-blind trial, 66 hemodialysis patients were administered either 15 mg of folic acid or an equimolar amount (16.1 mg) of folinic acid intravenously three times weekly. Normalization of total homocysteine (tHcy) plasma levels after 4 weeks of treatment was achieved in 10 patients (30.3%) in the folic-acid group and 6 patients (18.2%; P: = 0.389) in the folinic-acid group (normalization at any time during the study period in 39.4% and 33.3% of the patients; P: = 0.798). The relative reduction in tHcy plasma levels at week 4 was 32.2% in the folic-acid group and 34.1% in the folinic-acid group. A high baseline tHcy plasma concentration (P: = 0.00001), methylenetetrahydrofolate reductase (MTHFR) 677TT/1298AA genotype (P: = 0.03540), and low red blood cell folate concentrations (P: = 0.02285) were associated with a better relative response to treatment. Normalization of tHcy plasma levels was dependent on a lower baseline tHcy level (P: = 0.01976), younger age (P: = 0.00896), and MTHFR 677TT/1298AA or 677CT/1298AC genotypes (P: = 0.00208 and P: = 0.02320, respectively). A 4-week course of intravenous folinic acid is not superior to intravenous folic acid in reducing elevated tHcy plasma levels in hemodialysis patients. The response to treatment is predicted by tHcy plasma level, red blood cell folate content, and MTHFR genotype.
Authors:
A C Hauser; W Hagen; P H Rehak; H Buchmayer; M Födinger; M Papagiannopoulos; C Bieglmayer; R Apsner; E Köller; M Ignatescu; W H Hörl; G Sunder-Plassmann
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  37     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-03-29     Completed Date:  2001-05-24     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  758-65     Citation Subset:  IM    
Affiliation:
Department of Medicine III, Division of Nephrology and Dialysis, University of Vienna, Austria.
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MeSH Terms
Descriptor/Qualifier:
Double-Blind Method
Drug Administration Schedule
Erythrocytes / chemistry
Female
Folic Acid / administration & dosage,  blood,  therapeutic use*
Genotype
Homocysteine / blood
Humans
Hyperhomocysteinemia / blood,  drug therapy*
Infusions, Intravenous
Leucovorin / administration & dosage,  therapeutic use*
Male
Methylenetetrahydrofolate Reductase (NADPH2)
Middle Aged
Oxidoreductases Acting on CH-NH Group Donors / blood,  genetics
Pyridoxine / blood
Renal Dialysis*
Treatment Outcome
Vitamin B 12 / blood
Chemical
Reg. No./Substance:
454-28-4/Homocysteine; 58-05-9/Leucovorin; 59-30-3/Folic Acid; 65-23-6/Pyridoxine; 68-19-9/Vitamin B 12; EC 1.5.-/Oxidoreductases Acting on CH-NH Group Donors; EC 1.5.1.20/Methylenetetrahydrofolate Reductase (NADPH2)

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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