Folate measurements in patients on regular hemodialysis treatment

Bamonti-Catena, F.; Buccianti, G.; Porcella, Antonella; Valenti, G; Como, Giovanna; Finazzi, Silvia; Maiolo, Anna Teresa

doi:10.1016/s0272-6386(99)70186-1

Cited by 28 publications

(28 citation statements)

References 12 publications

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“…Finally, in agreement with Gonzalez-Gross's observation (24), and on the basis of our own experience, given the high prevalence of hyperhomocysteinemia (frequently due to vitamin B deficiency) careful monitoring of the metabolic markers of cobalamin status is suggested (26,27).…”

Section: Discussionsupporting

confidence: 82%

Determination of serum holotranscobalamin concentrations with the AxSYM active B₁₂ assay: cut-off point evaluation in the clinical laboratory

Bamonti

Moscato

Novembrino

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: A reliable early marker is required for diagnosis of cobalamin deficiency. We calculated an appropriate holotranscobalamin (HoloTC) cut-off point for identifying cobalamin deficiency using an immunoenzymatic assay. Methods: Determination of the cut-off threshold and correlation between HoloTC and the other diagnostic parameters routinely used for vitamin B 12 deficiency wtotal vitamin B 12 (tB 12 ), folate, homocysteinex were measured in 250 routine blood specimens from 107 men (mean age 59.0"18.8 years) and 143 women (mean age 54.2"23.1 years). The inclusion criterion was serum tB 12 concentration F221 pmol/L. Results: Analytical performance results agreed with those reported by others. A weak correlation (Rs0.42) was found between HoloTC and tB 12 . A 40 pmol/L cut-off threshold was chosen for HoloTC and the associated sensitivity and

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Section: Discussionsupporting

confidence: 82%

Determination of serum holotranscobalamin concentrations with the AxSYM active B₁₂ assay: cut-off point evaluation in the clinical laboratory

Bamonti

Moscato

Novembrino

et al. 2009

Clinical Chemistry and Laboratory Medicine

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“…This finding was confirmed by our group in a recent study in which we compared both serum and erythrocyte folate concentrations, the latter being definitely a more reliable indicator of folate metabolism [5]. However, high circulating homocysteine levels represent an independent risk factor for cardiovascular disease, and folic acid supplementation reduces the pretreatment homocysteine plasma levels by 25-35%, with a further 7% reduction when vitamin B 12 supplementation is administered [6,7].…”

Section: Introductionsupporting

confidence: 59%

Reduction of the Homocysteine Plasma Concentration by Intravenously Administered Folinic Acid and Vitamin B<sub>12</sub> in Uraemic Patients on Maintenance Haemodialysis

et al. 2001

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Background: Hyperhomocysteinaemia is an independent cardiovascular risk factor which can induce vascular lesions, thus contributing to the early development of atherosclerosis. Low-dose folic acid supplementation reduces the pretreatment homocysteine plasma levels by 25–35%. Recent studies report that higher intravenous or oral administration of the active form of folic acid reduces the homocysteine plasma concentration by nearly 70%. The reduction could also be influenced by the thermolabile variant of methylenetetrahydrofolate reductase (tMTHFR) and by the dialysis modality. Methods: A cross-sectional clinical study was performed to evaluate the effect of a drug containing folinic acid and vitamin B₁₂ on the plasma homocysteine concentration and whether this variable could also be influenced by the presence of a genetic variant of the methionine pathway and the use of different dialysis modalities. The plasma homocysteine concentration was measured in 55 patients undergoing haemodialysis, 27 of whom have been treated intravenously for megaloblastic anaemia using a drug containing low concentrations of folinic acid and vitamin B₁₂ at the end of each dialysis session for 6 months. The presence of tMTHFR was sought by molecular analysis, and the role of the dialysis modality was also investigated. Results: The patients given the folic acid treatment had lower homocysteine plasma levels than those not so treated. The plasma homocysteine concentration was significantly higher in the tMRHFR homozygotes than in the patients with a normal genotype, significantly lower in the treated than in the untreated homozygotes, and significantly higher in the untreated homozygotes than in the untreated subgroup with a normal genotype. The homocysteine level was also significantly lower in the patients who underwent convective haemodialysis than in those who received standard bicarbonate dialysis. Conclusions: A drug containing low concentrations of folinic acid combined with vitamin B₁₂ using an intermittent intravenous regimen is effective in reducing the homocysteine plasma concentration in uraemic patients. The homocysteine levels seem also to depend on genotype and dialysis modality.

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“…The incidence of folate deficiency in CAPD patients or haemodialysis patients is dramatically overestimated by using common cut-off values of normal serum folate concentrations [14]. Bamonti-Catena and co-workers found low serum folate levels in 63% of their patients, but more than 80% of these patients had RBC folate concentrations within the normal range [15].…”

Section: Discussionmentioning

confidence: 99%

Folic acid deficiency modifies the haematopoietic response to recombinant human erythropoietin in maintenance dialysis patients

Schiffl¹,

Lang²

2005

Nephrology Dialysis Transplantation

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Background. While folic acid deficiency causes macrocytic anaemia in non-renal patients, the relevance of altered folate metabolism in anaemia of end-stage renal disease and its response to rHu-EPO is less clear. Methods. Ten haemodialysis patients with macrocytic anaemia due to dietary folic acid deficiency were compared to 10 matched (age, duration of dialysis, degree of anaemia) patients with normocytic normochromic anaemia. Ninteen patients received erythropoietin-alpha intravenously thrice weekly. The study design was a prospective crossover (ABA) comparison of the effects of intravenously administered high doses of folic acid on haemoglobin levels and EPO doses, with 6 months active supplementation (B) and two periods of 6 months duration each without folic acid supplementation (A). Results. The two patient groups did not differ at recruitment. Red blood cell folate levels were normal in patients with normocytic anaemia, but they were subnormal in all patients with macrocytic anaemia. Compared to the first period without folic acid supplementation, patients with macrocytic anaemia had significantly higher haemoglobin levels despite lower EPO doses after 6 months high-dose folic acid, and red cells had become normocytic. The removal of folic acid supplementation resulted in re-occurrence of macrocytosis and in a significantly lower response to rHu-EPO. In contrast, high-dose folic acid supplementation had no effect on response to rHu-EPO in patients with normocytic anaemia. Conclusions. Folic acid deficiency may occur in elderly haemodialysis patients with poor dietary folate intake without regular oral supplementation and may cause hyporesponsiveness to rHu-EPO. Macrocytosis is a simple and cheap indicator for folate deficiency in end-stage renal disease patients on maintenance dialysis.

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Folate measurements in patients on regular hemodialysis treatment

Cited by 28 publications

References 12 publications

Determination of serum holotranscobalamin concentrations with the AxSYM active B₁₂ assay: cut-off point evaluation in the clinical laboratory

Determination of serum holotranscobalamin concentrations with the AxSYM active B₁₂ assay: cut-off point evaluation in the clinical laboratory

Reduction of the Homocysteine Plasma Concentration by Intravenously Administered Folinic Acid and Vitamin B<sub>12</sub> in Uraemic Patients on Maintenance Haemodialysis

Folic acid deficiency modifies the haematopoietic response to recombinant human erythropoietin in maintenance dialysis patients

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Folate measurements in patients on regular hemodialysis treatment

Cited by 28 publications

References 12 publications

Determination of serum holotranscobalamin concentrations with the AxSYM active B12 assay: cut-off point evaluation in the clinical laboratory

Determination of serum holotranscobalamin concentrations with the AxSYM active B12 assay: cut-off point evaluation in the clinical laboratory

Reduction of the Homocysteine Plasma Concentration by Intravenously Administered Folinic Acid and Vitamin B<sub>12</sub> in Uraemic Patients on Maintenance Haemodialysis

Folic acid deficiency modifies the haematopoietic response to recombinant human erythropoietin in maintenance dialysis patients

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Determination of serum holotranscobalamin concentrations with the AxSYM active B₁₂ assay: cut-off point evaluation in the clinical laboratory

Determination of serum holotranscobalamin concentrations with the AxSYM active B₁₂ assay: cut-off point evaluation in the clinical laboratory