Folate supplementation in peritoneal dialysis patients with normal erythrocyte folate: Effect on plasma homocysteine

Amedeo F. De Vecchi, Cristina Patrosso, Cristina Novembrino, Silvia Finazzi, Patrizia Colucci, Michela De Franceschi, Maria Antonietta Fasano, Fabrizia Bamonti-Catena

Research output: Contribution to journalArticle

Abstract

The possible role of folate supplementation in reducing hyperhomocysteinemia in dialysis patients has been reported in several recent papers. However, scant data are available for peritoneal dialysis patients; besides, none of these studies investigated either the role of intra-erythrocyte folate concentration or the presence of side effects caused by folate administration. Sixty-six peritoneal dialysis patients with hyperhomocysteinemia (>15 μmol/l) and normal folate status (as assessed by erythrocyte folate level>600 nmol/l) were randomly allocated to receive either oral folate (5 mg/day) or no vitamin supplementation. After 2 months of therapy, patients were requested to answer a questionnaire investigating the occurrence of symptoms possibly related to folate supplementation. Twenty-nine treated patients and 30 untreated controls completed the study. In the treated patients, serum and erythrocyte folate increased significantly (p <0.0001) (respectively from 10.6 ± 4.9 to 237 ± 231 nmol/l and from 1,201 ± 297 to 2,881 ± 294 nmol/l) to levels at the uppermost limit of detection by laboratory methods. Serum vitamin B12 levels did not change. Plasma homocysteine levels decreased from 54 ± 32 to 23 ± 14 μmol/l after folate supplementation and remained unchanged in the control group. After 4 months of folate therapy, homocysteine concentration was within the normal range in 5 patients (17%) and below 30 μmol/l in the other 21 (72%). Folate therapy resulted in a decrease in homocysteine of more than 50% in 45% of the patients and decrease of more than 20% in a further 38%. No significant symptoms were reported. Thus, serum and erythrocyte folate increase confirms that normal folate levels are inadequate in dialysis patients, even if serum and erythrocyte levels before folate supplementation cannot predict the effect on homocysteine plasma levels.

Original languageEnglish
Pages (from-to)297-302
Number of pages6
JournalNephron
Volume89
Issue number3
DOIs
Publication statusPublished - 2001

Keywords

  • Erythrocyte folate
  • Folate supplementation
  • Folate therapy
  • Homocysteine
  • Peritoneal dialysis
  • Serum folate
  • Vitamin B

ASJC Scopus subject areas

  • Nephrology

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  • Cite this

    De Vecchi, A. F., Patrosso, C., Novembrino, C., Finazzi, S., Colucci, P., De Franceschi, M., Fasano, M. A., & Bamonti-Catena, F. (2001). Folate supplementation in peritoneal dialysis patients with normal erythrocyte folate: Effect on plasma homocysteine. Nephron, 89(3), 297-302. https://doi.org/10.1159/000046089