van Guldener C, Janssen MJFM, Stehouwer CDA, ter Wee PM,
Donker AJM
Treatment of hyperhomocysteinemia in chronic dialysis patients
with folic acid and betaine
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1502 1996
Folic acid has been showed to reduce plasma homocysteinemia, a well
established cardiovascular risk factor in dialysis patients. 61 pts (35
MHD, 26 CPD) all started a supplement of 5 mg folic acid daily and were
randomized to receive 2 g betaine (B+) or not (B-). Measurements were done
at baseline, then 1 and 12 week after starting the supplement. Plasma
homocysteine was elevated in both groups (about 45 umol/l) at baseline,
decrease
to about 25 umol/l at one week, and 21 umol/l at 12 week (more than 50%
reduction in both groups). However, there was no difference between groups,
whether or not betaine was given. Subgroups analysis were done between MHD
and CPD in each group, but it is not possible from the abstract to
differentiate those receiving or not receiving betaine.
Comment: The authors conclude that folate supplement is effective
in reducing plasma
homocysteinemia in maintenance dialysis patients, but adding betaine does
not further improve this status.
(Denis Fouque, M.D., University of Lyons, France)
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Am Soc Nephrol
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