| Efficacy of folinic versus folic acid for the correction of hyperhomocysteinemia in hemodialysis patients. | |
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MedLine Citation:
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PMID: 11273876 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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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:
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Created Date: 2001-03-29 Completed Date: 2001-05-24 Revised Date: 2005-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8110075 Medline TA: Am J Kidney Dis Country: United States |
Other Details:
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Languages: eng Pagination: 758-65 Citation Subset: IM |
Affiliation:
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Department of Medicine III, Division of Nephrology and Dialysis, University of Vienna, Austria. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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