title: Treatment of hyperhomocysteinemia in renal transplant recipients. A randomized, placebo-controlled trial.
abstract: BACKGROUND
  Stable renal transplant recipients have an excess prevalence of hyperhomocysteinemia, which is a risk factor for arteriosclerosis.
  
  
  OBJECTIVE
  To determine the effect of treatment with 1) vitamin B6 or 2) folic acid plus vitamin B12 on fasting and post-methionine-loading plasma total homocysteine levels in renal transplant recipients.
  
  
  METHODS
  Block-randomized, placebo-controlled, 2 x 2 factorial study.
  
  
  METHODS
  University-affiliated transplantation program.
  
  
  METHODS
  29 clinically stable renal transplant recipients.
  
  
  METHODS
  Patients were randomly assigned to one of four regimens: placebo (n = 8); vitamin B6, 50 mg/d (n = 7); folic acid, 5 mg/d, and vitamin B12, 0.4 mg/d (n = 7); or vitamin B6, 50 mg/d, folic acid, 5 mg/d, and vitamin B12, 0.4 mg/d (n = 7).
  
  
  METHODS
  Fasting and 2-hour post-methionine-loading plasma total homocysteine levels.
  
  
  RESULTS
  Vitamin B6 treatment resulted in a 22.1% reduction in geometric-mean post-methionine-loading increases in plasma total homocysteine levels (P = 0.042), and folic acid plus vitamin B12 treatment caused a 26.2% reduction in geometric-mean fasting plasma total homocysteine levels (P = 0.027). These results occurred after adjustment for age; sex; and pretreatment levels of total homocysteine, B vitamins, and creatinine.
  
  
  CONCLUSIONS
  Vitamin B6 should be added to the combination of folic acid and vitamin B12 for effective reduction of both post-methionine-loading and fasting plasma total homocysteine levels in renal transplant recipients.
authors.affiliation: Jean Mayer USDA Human Nutrition Research Center, Boston, Massachusetts, USA.
authors.forename: A G
authors.initials: AG
authors.lastname: Bostom
authors.forename: R Y
authors.initials: RY
authors.lastname: Gohh
authors.forename: A J
authors.initials: AJ
authors.lastname: Beaulieu
authors.forename: M R
authors.initials: MR
authors.lastname: Nadeau
authors.forename: A L
authors.initials: AL
authors.lastname: Hume
authors.forename: P F
authors.initials: PF
authors.lastname: Jacques
authors.forename: J
authors.initials: J
authors.lastname: Selhub
authors.forename: I H
authors.initials: IH
authors.lastname: Rosenberg
mesh_terms: D004359:Drug Therapy, Combination; D005163:Factor Analysis, Statistical; D005492:Folic Acid / Q000627:therapeutic use; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008715:Methionine; D011736:Pyridoxine / Q000627:therapeutic use; D012307:Risk Factors; D014805:Vitamin B 12 / Q000627:therapeutic use
chemical_list: D006710:Homocysteine; D005492:Folic Acid; D008715:Methionine; D011736:Pyridoxine; D014805:Vitamin B 12