Homocysteine, fibrinogen, and lipoprotein(a) levels are simultaneously reduced in patients with chronic renal failure treated with folic acid, pyridoxine, and cyanocobalamin.
Ischemic heart disease and other complications of atherosclerosis are the usual cause of death in patients with chronic renal failure. Important factors associated with early onset of atherosclerosis in these patients are hyperhomocysteinemia, hyperfibrinogenemia, and elevated levels of lipoprotein(a) (Lp(a)). Folic acid (15 mg/d), pyridoxine (150 mg/d), and cyanocobalamin (1 mg/wk) were administered for 4 weeks in 21 patients receiving dialysis, and a simultaneous, statistically significant reduction in the concentration of homocysteine, fibrinogen, and Lp(a) was found. A positive correlation between decreasing homocysteine and fibrinogen levels was also noted. The parameters studied approached presupplementation values 6 months after vitamins were discontinued. The results suggest that vitamin supplementation has a favorable effect on risk factors of atherosclerosis in patients with renal failure and that interactions may exist between homocysteine, fibrinogen, and Lp(a).
Regional Center for Atherosclerosis Research, Pomeranian Academy of Medicine, and the Dialysis Unit of the Provincial Hospital, Szczecin, Poland.
M
M
Naruszewicz
M
M
Klinke
K
K
Dziewanowski
A
A
Staniewicz
H
H
Bukowska
D000328:Adult; D001161:Arteriosclerosis / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D003404:Creatinine / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005492:Folic Acid / Q000494:pharmacology / Q000627:therapeutic use; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D011736:Pyridoxine / Q000494:pharmacology / Q000627:therapeutic use; D006435:Renal Dialysis; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014508:Urea / Q000097:blood; D014527:Uric Acid / Q000097:blood; D014805:Vitamin B 12 / Q000494:pharmacology / Q000627:therapeutic use; D014803:Vitamin B Complex / Q000494:pharmacology* / Q000627:therapeutic use*
D017270:Lipoprotein(a); D014280:Triglycerides; D006710:Homocysteine; D014803:Vitamin B Complex; D014527:Uric Acid; D014508:Urea; D005340:Fibrinogen; D005492:Folic Acid; D002784:Cholesterol; D003404:Creatinine; D011736:Pyridoxine; D014805:Vitamin B 12