| Role of folate deficiency on erythropoietin resistance in pediatric and adolescent patients on chronic dialysis. | |
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MedLine Citation:
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PMID: 16133045 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Unlike iron therapy, folate use is not a standard of care in hemodialysis (HD) patients. Despite iron repletion, poor response to erythropoietin (EPO) treatment is common. Theoretical evidence for folate deficiency (FD) includes chronic blood loss, inflammation, malnutrition, and nutrient loss during dialysis. Due to poor diagnostic standards, early studies failed to establish a role for FD in EPO resistance. Given that hematological response to therapeutic intervention is the gold standard for FD, its diagnosis was therefore based on composite scoring of RBC and/or folate indices. Fifteen subjects (8-20 years) on chronic HD were enrolled in this study. No folate supplement was given in the first six months. Thereafter, 5-mg folic acid was administered orally after HD sessions over a six-month period. Folate indices before and after treatment were compared using percentage differences and paired t-tests. After folate use, the mean Hb increased by 11.4%, while MCV and RDW were reduced. Similarly, 4 of the 15 subjects each had a > or = 20% rise in Hb and a > or = 5% reduction in MCV, while 46.7% had a > or = 2.5% reduction in RDW. Mean RBC folate increased by 24%, while FD scores reduced from 3.8+/-1.2 to 0.4+/-0.7, and the EPO requirement by 90%. In contrast to previous studies, 26.7% of study subjects met the criteria for FD. Furthermore, the substantial (post-folate) reduction in the EPO requirement validates the need for therapeutic intervention, and therefore the presence of functional FD in the population. |
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Authors:
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Oluwatoyin Fatai Bamgbola; Frederick Kaskel |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2005-08-20 |
Journal Detail:
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Title: Pediatric nephrology (Berlin, Germany) Volume: 20 ISSN: 0931-041X ISO Abbreviation: Pediatr. Nephrol. Publication Date: 2005 Nov |
Date Detail:
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Created Date: 2005-10-06 Completed Date: 2006-03-29 Revised Date: 2009-11-03 |
Medline Journal Info:
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Nlm Unique ID: 8708728 Medline TA: Pediatr Nephrol Country: Germany |
Other Details:
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Languages: eng Pagination: 1622-9 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, Oklahoma University Health Science Center, 940 13th Street, Rm 2B2309, Oklahoma City, OK 73104, USA. Oluwatoyin-Bamgbola@ouhsc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Anemia, Iron-Deficiency / blood, complications, drug therapy* Child Drug Resistance Erythropoietin, Recombinant / therapeutic use* Female Folic Acid / blood, therapeutic use Folic Acid Deficiency / blood, complications*, diagnosis, drug therapy Hemoglobins / analysis Humans Kidney Failure, Chronic / complications*, therapy Male Renal Dialysis* / adverse effects Vitamin B 12 / blood |
| Grant Support | |
ID/Acronym/Agency:
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9-526-3740//PHS HHS |
| Chemical | |
Reg. No./Substance:
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0/Erythropoietin, Recombinant; 0/Hemoglobins; 59-30-3/Folic Acid; 68-19-9/Vitamin B 12 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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