Homocysteine and folic acid levels in hemodialysis patients treated with sevelamer hydrochloride.
OBJECTIVE
Folic acid deficiency has been reported to elevate plasma homocysteine levels and result in hyperhomocystinemia, which is an independent risk factor for cardiovascular disease. Sevelamer hydrochloride has the potential to bind with folic acid. To determine this effect of sevelamer hydrochloride on plasma homocysteine levels, change in serum folic acid and plasma homocysteine levels after administration of sevelamer hydrochloride in chronic hemodialysis patients was evaluated.


METHODS
Sevelamer hydrochloride was administered to 26 outpatients undergoing hemodialysis for 3 months. Serum and plasma samples were collected just before the dialysis session at baseline and 3 months.


RESULTS
Three months after the administration of sevelamer hydrochloride, serum folic acid levels significantly decreased (baseline vs. 3 months; 5.48 +/- 1.81 vs. 4.79 +/- 1.79 ng/ml, p < 0.05), whereas plasma homocysteine levels significantly increased (baseline vs. 3 months; 50.8 +/- 35.9 vs. 67.6 +/- 44.7 nmol/ml, p < 0.01).


CONCLUSIONS
These findings suggest that sevelamer hydrochloride elevates plasma homocysteine levels, possibly by inhibiting the absorption of folic acid. Thus, the effect of sevelamer hydrochloride should be excluded while evaluating the increased plasma levels of homocysteine.
Goto
S
S
Division of Nephrology and Kidney Center, Kobe University, School of Medicine, Kobe, Japan.
Fujii
H
H
Kim
J-I
JI
Fukagawa
M
M
D002614:Chelating Agents / Q000378:metabolism / Q000494:pharmacology*; D005260:Female; D005492:Folic Acid / Q000097:blood* / Q000378:metabolism; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011073:Polyamines / Q000378:metabolism / Q000494:pharmacology*; D006435:Renal Dialysis; D000069603:Sevelamer
D002614:Chelating Agents; D011073:Polyamines; D006710:Homocysteine; D005492:Folic Acid; D000069603:Sevelamer