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• W2034685089 abstract "Introduction: Hyperhomocyst(e)inemia (plasma homocyst(e)ine concentration >16.0 μmol/l) is an independent risk factor for atherosclerosis, and is ubiquitous in patients with end-stage renal disease (ESRD). Oral folate supplementation in the non-ESRD population has been demonstrated to reduce plasma homocyst(e)ine (Hcy) concentration, and may reduce atherosclerotic morbidity. This study was undertaken to evaluate the efficacy of folate supplementation in reducing Hcy in patients with ESRD and cardiovascular disease. Methods: Twenty-eight chronic hemodialysis patients with demonstrated hyperhomocyst(e)inemia (mean Hcy 35.2±13.3 μmol/l) were enrolled in the study. The presence of atherosclerosis was documented by history, physical examination, or ultrasonographic criteria. Hcy was determined initially and following six weeks' supplementation with 5.0 mg folate and multvitamins. Results: Hcy fell a mean of 15.0±10.4 μmol/l (38.9±19.9%) following supplementation (p<0.0005, paired t-test). In patients whose Hcy `normalized' (n=10) Hcy fell a mean of 51±14% compared to a reduction of 32±20% in 18 patients whose Hcy remained >16.0 μmol/l (p=0.02). A significant positive correlation was observed between initial Hcy and both absolute and percent reduction after folate supplementation (r=0.87, p<0.005 and 0.53, p<0.005, respectively). Seven patients with documented atherosclerosis were older (68±8 yr vs 51±5 yr, p=0.007) an tended to have lower initial and final Hcy than the 21 patients without atherosclerosis (26.8±9.9 vs 38.0±13.3 μmol/l, p=0.051 and 16.5±5.0 vs 21.3±6.7, p=0.06, respectively). The presence of atherosclerosis was not associated with significant alteration in the response to folate. Conclusions: Supplementation with high-dose folate significantly reduces plasma Hcy in patients with and without atherosclerosis, and the presence of atherosclerosis does not impact on patients' response to folate and multivitamin supplementation. Hcy remained >16.0 μmol/l in the majority of patients, however, despite large absolute reductions in Hcy. Doses of folate greater than 5 mg, or additional therapy may be required to further reduce Hcy in the majority of ESRD patients." @default.
• W2034685089 created "2016-06-24" @default.
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• W2034685089 date "2000-12-01" @default.
• W2034685089 modified "2023-09-24" @default.
• W2034685089 title "Oral folate reduces plasma homocyst(e)ine levels in hemodialysis patients with cardiovascular disease" @default.
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• W2034685089 doi "https://doi.org/10.1016/s0967-2109(00)00062-4" @default.
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