[Resistance of hyperhomocysteinemia in renal patients to treatment with supra-physiological doses of parenteral folic acid].
Hemodialysis patients present an increase in plasma homocysteine (Hcy) due to methylation impairment caused by uremia and the deficiency of the co-factors needed (vitamin B, folic acid). This correlates with a more common development of premature vascular disease. There is no consensus on the therapy, with a poor response to oral administration of conventional doses of folic acid. In this work, we assessed the response of hyperhomocysteinemia in 73 regular hemodialysis patients after the administration of 50 mg of parenteral folinic acid for 18 months. Plasma homocysteine of the patients at the time of the study beginning presented mean values of 22.67 (micromol/L). During the first year of supplementation the mean value was kept at 20 micromol/L. From the first year to the end of the 18-months observation period the mean homocysteine levels were 19.58 micromol/L. Although we found a clear trend towards a decrease in plasma homocysteine levels during the treatment period, there were no significant differences. Homocysteine levels did not come back to normal in none of the patients treated.
Servicio de Nefrología, Ciudad Sanitaria Virgen de las Nieves, Granada, España.
M Palomares
MP
Bayo
M J Oliveras
MJ
López
A Osuna
AO
Ortega
C Asensio
CA
Peinado
J J Quesada
JJ
Granados
H López García
HL
de la Serrana
M C López
MC
Martínez
D004351:Drug Resistance; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000188:drug therapy*; D002955:Leucovorin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000628:therapy
D002955:Leucovorin