1. Parenteral vitamin B12 therapy of hyperhomocysteinemia in end-stage renal disease.
- Author
-
Hoffer LJ and Elian KM
- Subjects
- Administration, Oral, Aged, Folic Acid blood, Folic Acid therapeutic use, Humans, Methylmalonic Acid blood, Middle Aged, Parenteral Nutrition, Time Factors, Vitamin B 12 Deficiency therapy, Hyperhomocysteinemia drug therapy, Kidney Failure, Chronic therapy, Vitamin B 12 therapeutic use
- Abstract
Background: End-stage renal disease (ESRD) is associated with moderately severe hyperhomocysteinemia that is incompletely normalized by oral folic acid therapy and vitamin B12., Method: We administered 1 mg hydroxocobalamin parenterally at 14-day intervals to vitamin B12-replete hemodialysis patients who were already consuming 6 mg folic acid daily by mouth. Plasma total homocysteine (tHcy), serum folate, vitamin B12 and methylmalonate were measured immediately before and after 4 and 8 weeks of therapy., Results: Serum folate concentrations were consistently over 25 times the upper normal limit. Hydroxocobalamin therapy increased serum vitamin B12 concentrations 14-fold (p < 0.001) and reduced plasma tHcy by 23% from 29.7 +/- 2.9 to 22.8 +/- 2.5 micromol/L (p < 0.01); serum methylmalonate decreased by one-third (p < 0.05)., Conclusions: These results demonstrate the Hcy-lowering potential of parenteral vitamin B12 in folic acid supplemented vitamin B12-replete hemodialysis patients, and indicate the need for formal dose-optimization studies of this simple, inexpensive and promising approach to Hcy reduction in end-stage renal disease.
- Published
- 2004