Folic Acid and Vitamin B12 Administration in CKD, Why Not?

Capelli, Irene; Cianciolo, Giuseppe; Gasperoni, Lorenzo; Zappulo, Fulvia; Tondolo, Francesco; Cappuccilli, Maria; Manna, Gaetano La

doi:10.3390/nu11020383

Cited by 90 publications

(85 citation statements)

References 131 publications

(150 reference statements)

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“…Our findings extend those of previous papers reporting that treatment with folic acid (2.5 -15 mg/d) may reduce Hcy concentrations in CKD (House et al, 2010;Wu, 2012;Righetti et al, 2006;Vianna et al, 2007;Cianciolo et al, 2008). Some reviews (Clase;Ki;Holden 2013;Cianciolo et al 2017;Capelli et al 2019) discuss that the beneficial effects of folic acid therapy may be due to its direct effects or to a reduction of hyperhomocysteinemia in patients with CKD.…”

Section: Discussionmentioning

confidence: 99%

Tratment With Folic Acid Increases Paraoxonase 1 Activity Thereby Improving Chronic Kidney Disease

Matsumoto¹,

Maes²,

Michelin³

et al. 2020

Preprint

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Introduction: Increased oxidative stress, including elevated homocysteine (Hcy) plasma levels, and lowered levels of antioxidants participate in the pathophysiology and progression of chronic kidney disease (CKD). Paraoxonase (PON)1 activity and folic acid are antioxidants which play a role in Hcy metabolism. However, there are no data whether, in CKD, treatment with folic acid improves glomerular filtration rate (GFR) through effects on PON1 activity and Hcy concentrations. Methods: In the current study, we determined PON1 genotypes and activity, Hcy and estimated GFR (eGFR) both before and after treatment with folic acid (5 mg/d) versus no treatment during three consecutive months in 113 outpatients with CKD classified into stages 4, 3b and 3a. Results: PON1 CMPAase and AREase activities were significantly lower in patients allocated to CKD stage 4 as compared with stages 3b and 3a. Treatment with folic acid significantly improved eGFR and increased levels of CMPAase and AREase in patients allocated to classes 4 and 3b, but not 3a. The improvement of eGFR was associated with increased CMPAase and AREase activities, while the latter were associated with increased levels of folic acid. Treatment with folic acid significantly reduced plasma Hcy levels and the Hcy/PON1 activity ratio. The effects of folic acid increasing PON1 activities were not mediated by changes in Hcy. Discussion: Treatment of CKD patients in early/intermediate stages of CKD patients improves oxidative stress by rebalancing the prooxidant (Hcy) / antioxidant (PON1 activities) ratio. Treatment with folic acid significantly improves eGFR and these effects are mediated via increased PON1 activities. Treatment with folic acid in phase G3b and G4 may reduce renal disease progression by enhancing antioxidant defenses.

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Section: Discussionmentioning

confidence: 99%

Tratment With Folic Acid Increases Paraoxonase 1 Activity Thereby Improving Chronic Kidney Disease

Matsumoto¹,

Maes²,

Michelin³

et al. 2020

Preprint

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“…In the folate cycle, folate transfers onecarbon moieties to different organic compounds, thus controlling SAM levels ( Figure 3). There is a large body of evidence to indicate that folate therapy improves HHcy in the general population, but the data are less clear in CKD patients [8,38,39].…”

Section: Folatementioning

confidence: 99%

“…vs. folic acid (5 mg/day oral) and found a better survival rate in patients treated with 5-MTHF, in spite of no significant differences between the groups in terms of HHcy amelioration [7]. There is a large body of evidence to indicate that folate therapy improves HHcy in the general population, but the data are less clear in CKD patients [8,38,39].…”

Section: Folatementioning

confidence: 99%

“…A special focus was given to the Homocysteine is regulated by the vitamin B group, namely vitamins B6 (pyridoxine), B9 (folic acid), and B12 (cobalamin). However, despite the beneficial effects of supplementation with these vitamins found on HHcy in the general population, less encouraging and sometimes inconsistent data have been reported in ESRD patients [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Vitamin B Supplementation and Nutritional Intake of Methyl Donors in Patients with Chronic Kidney Disease: A Critical Review of the Impact on Epigenetic Machinery

Cappuccilli

Bergamini²,

Giacomelli³

et al. 2020

Nutrients

Self Cite

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Cardiovascular morbidity and mortality are several-fold higher in patients with advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) than in the general population. Hyperhomocysteinemia has undoubtedly a central role in such a prominent cardiovascular burden. The levels of homocysteine are regulated by methyl donors (folate, methionine, choline, betaine), and cofactors (vitamin B6, vitamin B12,). Uremia-induced hyperhomocysteinemia has as its main targets DNA methyltransferases, and this leads to an altered epigenetic control of genes regulated through methylation. In renal patients, the epigenetic landscape is strictly correlated with the uremic phenotype and dependent on dietary intake of micronutrients, inflammation, gut microbiome, inflammatory status, oxidative stress, and lifestyle habits. All these factors are key contributors in methylome maintenance and in the modulation of gene transcription through DNA hypo- or hypermethylation in CKD. This is an overview of the epigenetic changes related to DNA methylation in patients with advanced CKD and ESRD. We explored the currently available data on the molecular dysregulations resulting from altered gene expression in uremia. Special attention was paid to the efficacy of B-vitamins supplementation and dietary intake of methyl donors on homocysteine lowering and cardiovascular protection.

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“…Produksi EPO akan meningkat pada keadaan anemia ataupun hipoksia jaringan (Ineck et al, 2008). Vitamin B12 merupakan nutrisi hematopoetik yang bekerja pada proses pembentukan sel darah merah (Bangbola, 2011;Capelli et al, 2019). Erythropoesis stimulating agent (ESA) bekerja dengan menstimulasi sumsum tulang untuk mempoduksi sel darah merah.…”

Section: Instrumenunclassified

Pengaruh Penggunaan Antianemia Terhadap Kadar Hemoglobin Pasien Gagal Ginjal Kronik

Meriyani¹,

Sartikawati²,

Putra³

2019

JINTO

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Anemia merupakan salah satu masalah kesehatan yang sering ditemukan pada pasien gagal ginjal kronis. Pemeriksaan hemogloblin rutin sangat disarankan pada pasien gagal ginjal kronis dengan anemia. Adapun tujuan dari penelitian ini adalah untuk mengetahui pengaruh penggunaan antianemia terhadap peningkatan kadar hemoglobin pada pasien gangguan ginjal kronis dengan komplikasi anemia. Penelitian ini merupakan penelitian non-eksperimental dengan rancangan cross sectional. Pengambilan data dilakukan secara retrospektif dengan menggunakan data rekam medis di RSUD Wangaya periode 2018. Untuk melihat pengaruh penggunaan antianemia dilakukan dengan membandingkan hemoglobin sebelum dengan sesudah terapi. Pasien gagal ginjal kronis yang menjadi subjek dalam penelitian ini yaitu berjumlah 64 orang. Sampel terdiri atas 64% laki laki dan 36 % perempuan. Berdasarkan profil penggunaan obat antianemia, sebanyak 95, 29% menggunakan obat asam folat; 1,57% menggunakan kombinasi eritropoetin-Fe sucrose-asam folat; sebanyak 1,57% menggunakan eritropoetin-asam folat; dan 1,57% menggunakan ferrous sulfat-asam folat. Dari hasil penelitian yang telah dilakukan, bahwa penggunaan antianemia pada pasien gagal ginjal kronik di Rumah Sakit Umum Daerah Wangaya periode 2018 dapat meningkatkan kadar hemoglobin pasien gagal ginjal kronis (p<0.05). dari penelitian ini dapat disimpulkan bahwa penggunaan antianemia telah efektif dalam meningkatkan kadar hemoglobin pasien dengan gagal ginjal kronis.

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Folic Acid and Vitamin B12 Administration in CKD, Why Not?

Cited by 90 publications

References 131 publications

Tratment With Folic Acid Increases Paraoxonase 1 Activity Thereby Improving Chronic Kidney Disease

Tratment With Folic Acid Increases Paraoxonase 1 Activity Thereby Improving Chronic Kidney Disease

Vitamin B Supplementation and Nutritional Intake of Methyl Donors in Patients with Chronic Kidney Disease: A Critical Review of the Impact on Epigenetic Machinery

Pengaruh Penggunaan Antianemia Terhadap Kadar Hemoglobin Pasien Gagal Ginjal Kronik

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