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Titolo:
Effective correction of hyperhomocysteinemia in hemodialysis patients by intravenous folinic acid and pyridoxine therapy
Autore:
Touam, M; Zingraff, J; Jungers, P; Chadefaux-Vekemans, B; Drueke, T; Massy, ZA;
Indirizzi:
Hop Necker Enfants Malad, INSERM, U507, Div Nephrol, F-75730 Paris 15, France Hop Necker Enfants Malad Paris France 15 phrol, F-75730 Paris 15, France Hop Necker Enfants Malad, Biochem Lab B, F-75730 Paris, France Hop Necker Enfants Malad Paris France F-75730 b B, F-75730 Paris, France
Titolo Testata:
KIDNEY INTERNATIONAL
fascicolo: 6, volume: 56, anno: 1999,
pagine: 2292 - 2296
SICI:
0085-2538(199912)56:6<2292:ECOHIH>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
STAGE RENAL-DISEASE; DIALYSIS PATIENTS; PLASMA FOLATE; HOMOCYSTEINE; SUPPLEMENTATION; ABSORPTION; LEUCOVORIN; RISK;
Keywords:
dialysis; folic acid; methyltetrahydrofolate; total homocysteine;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Massy, ZA Hop Necker Enfants Malad, INSERM, U507, Div Nephrol, 161 Rue Sevres, F-75730 Paris 15, France Hop Necker Enfants Malad 161 Rue Sevres Paris France 15 France
Citazione:
M. Touam et al., "Effective correction of hyperhomocysteinemia in hemodialysis patients by intravenous folinic acid and pyridoxine therapy", KIDNEY INT, 56(6), 1999, pp. 2292-2296

Abstract

Background. Folic acid supplementation is only partially efficacious in correcting moderate elevation of plasma total homocysteine (tHcy) concentrations observed in hemodialysis (HD) patients. Experimental and clinical data have suggested that this partial efficacy may be due to impairment of folicacid metabolism to 5-methyltetrahydrofolate (MTHF) and of MTHF transmembrane transport as well. To bypass these difficulties, we assessed the efficacy of intravenous (i.v.) folinic acid, a ready precursor of MTHF, on reducing plasma tHcy concentrations in HD patients. Methods. In a cohort of 37 patients on intermittent HD treatment, plasma tHcy concentrations were determined before and during i.v. supplementation of folinic acid (50 mg once per week), together with i.v. pyridoxine (250 mg3 times per week), to prevent vitamin deficiency, particularly in those treated by recombinant erythropoietin. Results. Folinic acid and pyridoxine i.v. supplementation was given for 11.2 +/- 2.45 months (range 7.5 to 17 months). The mean plasma tHcy levels decreased significantly from 37.3 +/- 5.8 mu M at baseline to 12.3 +/- 5.4 muM on folinic acid treatment (P < 0.001). Moreover, 29 of the 37 patients (78%) had normal plasma tHcy levels at the end of follow-up (that is, <14.1 mu M. mean 9.8 mu M. range 6.2 to 13 mu M). No adverse effects attributableto folinic acid treatment were observed during this time. Conclusions. Intravenous folinic acid therapy (50 mg) once per week associated with pyridoxine supplementation appears to be an effective and safe strategy to normalize plasma tHcy levels in the majority of chronic HD patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 13:29:27