The effect of vitamin B6 and folate supplements on plasma homocysteine and serum lipids levels in patients on regular hemodialysis.
BACKGROUND
Hyperhomocysteinemia is an independent risk factor for cardiovascular events. The aim of this study was to show the results of the reduction of homocysteine in end stage renal failure patients on hemodialysis, as it is known, have higher levels of homocysteine than other groups of subjects.


METHODS
Plasma homocysteine concentration was determined before and after the administration of vitamin B6 and folic acid in 12 patients (males: 6) on regular dialysis therapy. Mean monthly fasting serum concentrations of total cholesterol (TCHOL), HDL-chol, LDL-chol and triglycerides (TRG) were determined for a period 68 months (12-120 months) before and 26 months after the administration of vitamin B6 and folic acid.


RESULTS
Mean serum concentrations for folic acid and vitamin B12 before and after the administration were: folic acid: 5.03 +/- 4.9 and 18.0 +/- 19.2 ng/mL, (p < 0.0001) and B12: 456 +/- 257 and 514.38 +/- 307 pg/mL respectively). Plasma homocysteine was reduced significantly after the administration of above drugs (from 47 +/- 14 to 29 +/- 9 micromol/mL, p < 0.001). This reduction of homocysteine resulted in a modification of the patients' lipidemic profile: Serum LDL-chol was decreased significantly (119 +/- 38 mg/dL to 110 +/- 35 mg/dL, p<0.005). TCHOL and TRG were also decreased but not significantly (190 +/- 45 mg/dL to 187 +/- 43 mg/dL and 116 +/- 63 mg/dL to 108 +/- 47 mg/dL respectively)). Serum concentrations HDL-chol were increased significantly (from 42 +/- 10 mg/dL to 47 +/- 10 mg/dL, p < 0.001). The atherogenic index for cholesterol, LDL/HDL, was 1.6 times lower after the drugs receiving (before: LDL/HDL = 3.1 and after: LDL/HDL = 2.5, p < 0.001).


CONCLUSIONS
These results indicate that the folate and vitamin B6 supplementation resulted in reduction of homocysteine levels and improvement of lipidemic profile in regular dialysis patients.
Ziakka
S
S
Nephrology Department of Korgialenio-Benakio Hospital, Athens, Greece.
Rammos
G
G
Kountouris
S
S
Doulgerakis
C
C
Karakasis
P
P
Kourvelou
C
C
Papagalanis
N
N
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D006710:Homocysteine / Q000097:blood* / Q000187:drug effects; D006801:Humans; D020138:Hyperhomocysteinemia / Q000517:prevention & control; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012307:Risk Factors; D025101:Vitamin B 6 / Q000008:administration & dosage / Q000627:therapeutic use*
D008055:Lipids; D006710:Homocysteine; D025101:Vitamin B 6; D005492:Folic Acid