PMID- 11576930
OWN - NLM
STAT- MEDLINE
DCOM- 20011204
LR  - 20190815
IS  - 1523-6838 (Electronic)
IS  - 0272-6386 (Linking)
VI  - 38
IP  - 4 Suppl 1
DP  - 2001 Oct
TI  - Treatment of hyperhomocysteinemia in end-stage renal disease.
PG  - S91-4
AB  - Mild to moderate hyperhomocysteinemia (Hhcy) is observed in more than 90% of 
      patients with end-stage renal disease (ESRD) undergoing maintenance dialysis and 
      approximately 60% to 70% of chronic stable renal transplant recipients. The 
      reported association between Hhcy and the development of arteriosclerotic 
      cardiovascular disease may account, in part, for the disproportionate risk for 
      cardiovascular morbidity and mortality in patients with chronic renal disease. 
      Treatment with the recommended daily allowances of folic acid and vitamins B(6) 
      and B(12), which consistently normalizes total homocysteine (tHcy) levels in the 
      general population free of chronic renal disease, rarely results in the 
      normalization of tHcy levels in patients with ESRD. A large number of 
      investigations now have shown that even grossly supraphysiological doses of folic 
      acid and vitamins B(6) and B(12) fail to normalize tHcy levels in more than 90% 
      of dialysis-dependent patients with ESRD with baseline Hhcy. Conversely, such 
      treatment consistently normalizes tHcy levels among hyperhomocysteinemic chronic 
      stable renal transplant recipients or patients with mild to moderate renal 
      insufficiency. A randomized, placebo-controlled, tHcy-lowering intervention trial 
      involving approximately 4,000 chronic stable US renal transplant recipients (RO1 
      DK56486 01A2) will soon be underway to formally address the tenable hypothesis 
      that tHcy-lowering treatment may reduce the risk for arteriosclerotic outcomes. 
      Data from this trial should be applicable to patients with chronic renal 
      insufficiency in general.
FAU - Shemin, D
AU  - Shemin D
AD  - Division of Renal Diseases, Rhode Island Hospital, Brown University School of 
      Medicine, Providence, RI, USA. dshemin@lifespan.org
FAU - Bostom, A G
AU  - Bostom AG
FAU - Selhub, J
AU  - Selhub J
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Am J Kidney Dis
JT  - American journal of kidney diseases : the official journal of the National Kidney 
      Foundation
JID - 8110075
RN  - 0 (Tetrahydrofolates)
RN  - 8059-24-3 (Vitamin B 6)
RN  - 935E97BOY8 (Folic Acid)
RN  - P6YC3EG204 (Vitamin B 12)
RN  - TYK22LML8F (5-methyltetrahydrofolate)
SB  - IM
MH  - Folic Acid/administration & dosage
MH  - Humans
MH  - Hyperhomocysteinemia/etiology/*therapy
MH  - Kidney Failure, Chronic/*complications
MH  - Kidney Transplantation
MH  - Tetrahydrofolates/administration & dosage
MH  - Vitamin B 12/administration & dosage
MH  - Vitamin B 6/administration & dosage
RF  - 21
EDAT- 2001/09/29 10:00
MHDA- 2002/01/05 10:01
CRDT- 2001/09/29 10:00
PHST- 2001/09/29 10:00 [pubmed]
PHST- 2002/01/05 10:01 [medline]
PHST- 2001/09/29 10:00 [entrez]
AID - S0272-6386(01)89020-X [pii]
AID - 10.1053/ajkd.2001.27412 [doi]
PST - ppublish
SO  - Am J Kidney Dis. 2001 Oct;38(4 Suppl 1):S91-4. doi: 10.1053/ajkd.2001.27412.