Treatment of hyperhomocysteinaemia in haemodialysis patients at high cardiovascular risk

Cardiovascular disease (CVD) is the main cause of death among haemodialysis (HD) patients. Emerging cardiovascular risk factors such as oxidative stress and chronic inflammation are involved in these patients together with traditional risk factors. Here we investigate the effects of a short-term fol...

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Bibliographic Details
Published in:	Clinica terapeutica Vol. 160; no. 1; p. 11
Main Authors:	Manca di Villahermosa, S, Tedesco, M, Lonzi, M, Della Rovere, F R, De Francesco, M, Noce, A, Colarieti, G, Chamoun, G, Moscaritolo, E, Bernabei, E, Athanasopoulou, E, Di Giandomenico, G, Taccone-Gallucci, M
Format:	Journal Article
Language:	English
Published:	Italy 2009
Subjects:	Adult Aged Aged, 80 and over Cardiovascular Diseases - etiology Cardiovascular Diseases - prevention & control Female Folic Acid - therapeutic use Humans Hyperhomocysteinemia - complications Hyperhomocysteinemia - drug therapy Male Middle Aged Renal Dialysis Risk Factors Vascular Diseases - complications Vitamin B Complex - therapeutic use
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Summary:	Cardiovascular disease (CVD) is the main cause of death among haemodialysis (HD) patients. Emerging cardiovascular risk factors such as oxidative stress and chronic inflammation are involved in these patients together with traditional risk factors. Here we investigate the effects of a short-term folate treatment on some markers of chronic inflammation in two groups of HD patients with and without vascular occlusive disease (VOD). Homocysteine (HCy), C-reactive protein (CRP), Folate, fibrinogen and alpha1 acid glycoprotein (alpha1AGP) were dosed before and after a 3-month course of high-dose folate (25 mg intravenous calcium laevofolinate pentahydride once weekly) and again after a one-month washout in 15 HD patients with established VOD (group A) and in 15 comparable HD patients with no diagnosis of VOD (group B). Baseline HCy and CRP were significantly elevated in patients of both groups A and B compared to normal values. Folate treatment significantly reduced HCy in patients of both groups A and B and alpha1AGP only in patients of group A, while the other markers were not modified. After the one-month washout a significant raise of CRP could be observed in patients of group A; again, the other markers were not modified. Our results suggest that significant reduction of serum HCy can be achieved in both patients with or without VOD after administration of high-dose folic acid. Hence, folic acid supply is useful in the treatment of hyperhomocysteinemia in HD patients, although it is not sufficient to modify their chronic inflammatory status.
ISSN:	1972-6007