Folic acid supplementation to prevent adverse events in individuals with chronic kidney disease and end stage renal disease

Gonin, J

doi:10.1097/01.mnh.0000165896.98372.f4

Cited by 19 publications

(6 citation statements)

References 41 publications

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“…This is in agreement with other investigators who found no effect of folic acid on EDV, in spite of lowering homocysteine level, as hyperhomocysteinemia impairs endothelial function, which is not adequately reversed by folate [37][38][39].…”

Section: Discussionsupporting

confidence: 92%

Doppler assessment of brachial artery flow as a measure of endothelial dysfunction in pediatric chronic renal failure

et al. 2008

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Cardiovascular morbidity and mortality are highly prevalent among patients with chronic renal failure (CRF). Endothelial dysfunction is regarded as the initial reversible step in the development of atherosclerosis and has been demonstrated in all stages of renal failure. Non-invasive techniques to assess endothelial function have been recently developed and have been proven to predict future mortality in adults. We aimed to assess endothelial function in children with stage 4 chronic kidney disease (CKD 4) on conservative treatment, using a-non invasive, high-resolution, ultrasound Doppler study of the brachial artery flow, correlating it with other clinical and laboratory parameters. This study included 34 children with CKD 4 on conservative treatment who were compared with 30 healthy controls. Flow-mediated dilatation (FMD), nitroglycerin-mediated dilatation (NTG-MD) and FMD/NTG-MD ratio were estimated. FMD was abnormal (< 5%) in 24 patients (71%). FMD and FMD/NTG-MD ratio were significantly lower in patients than in controls (P = 0.001 and P = 0.01, respectively). FMD correlated positively with serum calcium and negatively with alkaline phosphatase. We concluded that endothelial dysfunction is present in children with CKD 4 on conservative treatment and may reflect increased atherogenic and thrombogenic properties of the endothelium, contributing to subsequent adverse cardiovascular outcome.

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Section: Discussionsupporting

confidence: 92%

Doppler assessment of brachial artery flow as a measure of endothelial dysfunction in pediatric chronic renal failure

et al. 2008

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“…Recent trials in the general population indicate that lowering homocysteine with the vitamins indicated above does not lower rates of CVD events 26 . Emerging data in patients with CKD also confirm this concept 27 . So despite the epidemiologic and pathophysiologic data on homocysteine and CVD, it appears that this protein will not be a clinical target in the future.…”

Section: Dyslipidemiassupporting

confidence: 59%

Interseção cardiorrenal: confluência para o futuro

McCullough¹

2007

Arq. Bras. Cardiol.

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“…Both F and ADMA play an important role in determining endothelium-dependent vasodilatation end-HD, suggesting that a reduced loss of F through the dialysis membrane and ⁄ or an increased elimination of ADMA might provide potential beneficial effects on endothelial function. F supplementation has been proposed as a safe and effective interventional strategy to slow the progression of vascular disease and to reduce cardiovascular morbidity and mortality in ESRD [40]. The initial argument supporting the use of F is based on the tHcy-lowering effects of this B-vitamin [41].…”

Section: Discussionmentioning

confidence: 99%

Acute effects of haemodialysis on biochemical modulators of endothelial function

Hewitson¹,

Whiting²,

Barbara

et al. 2007

Journal of Internal Medicine

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Objectives. To assess the acute effects of haemodialysis (HD) on biochemical factors modulating endothelial function.Setting. Academic medical centre.Subjects. Forty patients (age 63.5 ± 2.2 years, mean ± SEM) undergoing HD.Interventions. Folic acid (F), homocysteine (tHcy), asymmetric dimethylarginine (ADMA), high-sensitivity C-reactive protein (CRP) and malondialdehyde (MDA) were measured pre-HD, 1 h after commencing HD and within the last hour of HD (end-HD). Endothelium-dependent and -independent vasodilatation were measured by applanation tonometry (changes in augmentation index, AIx, postinhaled salbutamol and postsublingual nitroglycerin) in conjunction with biochemical measurements.Results. Marked reductions in serum F (616 ± 73 vs. 273 ± 30 nmol L )1 , P < 0.001), tHcy (16.3 ± 0.7 vs.11.2 ± 0.5 lmol L )1 , P < 0.001) and ADMA (0.64 ± 0.02 vs. 0.47 ± 0.02 lmol L )1 , P < 0.001) occurred end-HD, whereas CRP and MDA levels did not significantly change. There was no significant change in endothelium-dependent vasodilatation, whereas endothelium-independent vasodilatation improved end-HD ()23.1 ± 1.9 vs. )17.3 ± 1.3%, P = 0.018). Regression analysis showed that both higher ADMA (P = 0.029) and lower F levels (P = 0.040) end-HD were determinants of reduced endothelium-dependent vasodilatation end-HD (R 2 = 0.23).Conclusions. HD is associated with significant reductions in F, tHcy and ADMA serum concentrations. The lack of significant effects of HD on endotheliumdependent vasodilatation could be secondary to the concomitant loss of factors either enhancing (F) or impairing (ADMA) endothelial function.

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Folic acid supplementation to prevent adverse events in individuals with chronic kidney disease and end stage renal disease

Cited by 19 publications

References 41 publications

Doppler assessment of brachial artery flow as a measure of endothelial dysfunction in pediatric chronic renal failure

Doppler assessment of brachial artery flow as a measure of endothelial dysfunction in pediatric chronic renal failure

Interseção cardiorrenal: confluência para o futuro

Acute effects of haemodialysis on biochemical modulators of endothelial function

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