Effect of Vitamin B₁₂supplementation on serum homocysteine in patients undergoing hemodialysis: A randomized controlled trial

Abstract

Clinical studies have shown that hyper-homocysteinemia is a potent independent risk factor for cardiovascular diseases, and many different methods have been investigated for lowering it in hemodialysis (HD) patients. Our study investigated the effect of Vitamin B 12 supplementation on serum homocysteine levels in these patients. This randomized trial was conducted on 140 HD patients. They were randomly distributed by lottery method into two groups: intervention and control. In the intervention group, 100 μg/mL of Vitamin B 12 was intravenously injected two times a week, for eight weeks. No intervention was performed in the control group. Serum levels of homocysteine, hemoglobin (Hb), and hematocrit (Hct) were measured at the beginning and again after eight weeks (2 months) of treatment. About 91% of the patients had hyperhomocysteinemia (serum homocysteine >15 μmol/L). The median baseline levels of serum homocysteine in the intervention and control groups were 31.9 and 26.9 μmol/L, respectively (P = 0.1). After eight weeks, the median homocysteine level reduced significantly in the Vitamin B 12 group to 22.2 versus 28.4 μmol/L in control group (P = 0.006). The mean Hb and Hct also changed significantly during our study (12.3 vs. 11.4 g/dL; P = 0.003 and 37.9 vs. 35.3%; P = 0.02, respectively). Our results demonstrated the existence of a statistical negative relationship between Vitamin B 12 and serum levels of homocysteine. Detailed investigations with larger sample sizes and longer-term use of Vitamin B 12 are recommended.

Dietary Antioxidant Supplements and Uric Acid in Chronic Kidney Disease: A Review

“…All patients were randomly allocated to the treatment group that received intravenous 250 mg of Vitamin C thrice weekly after every HD session for two months and the two control groups that received either nothing or placebo intravenous normal saline. After the study period, compared to controls, the Vitamin C group exhibited a significant decrease in serum uric acid concentrations [78]. Moreover, Vitamin C supplementation resulted in a significant decrease of circulating CRP levels [79].…”

Role of Vitamin C in Prophylaxis and Treatment of Gout—A Literature Review

“…The oldest [ 44 , 46 , 47 ] were focused on the uricosuric effect of vitamin C supplementation. Further work focused on SUA levels in the healthy population and patients with various chronic diseases, including end-stage renal disease [ 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ]. The last subgroup consisted of studies where patients with gout in their clinical history were included [ 44 , 75 , 76 ].…”

Vitamin C Supplementation and Hyperuricemia: Fact or Hoax?

“…Likewise, many other meta-analysis of randomized controlled trails and cross sectional studies have reported the urate lowering effects of modest oral dosage of vitamin C supplements in hyperuricemic subjects, as well as the promising role of this viamin in risk reduction of gout [1,6,7,12]. Although, these previuos papers have evaluated the efficacy of oral vitamin C supplementaion on UA level, Biniaz et al [13] found that post-heamodialysis intravenous injection of vitamin C in hyperuricemic chronic kidney disease patients significantly reduces serum UA levels (p < 0.001) in comparison to control groups (p= 0.09 and p= 0.39).…”