A pilot study of thiamin and folic acid in hemodialysis patients with cognitive impairment

Abstract

Objective: This study aimed to explore the effectiveness of thiamin and folic acid supplementation on the improvement of the cognitive function in patients with maintenance hemodialysis. Method: In the present study, we randomly assigned patients undergoing hemodialysis who had the Montreal Cognitive Assessment (MoCA) score lower than 26 to treatment group (n ¼ 25, thiamin 90 mg/day combined with folic acid 30 mg/day) or control group (n ¼ 25, nonintervention). All subjects were followed up for 96 weeks. The primary outcome was the improvement of the MoCA score. The secondary outcomes included homocysteine level, survival and safety. Results: Patients in treatment group had an increase of the MoCA score from 21.95 ± 3.81 at baseline to 25.68 ± 1.96 at week 96 (p < 0.001, primary outcome), as compared with the MoCA score from 20.69 ± 3.40 to 19.62 ± 3.58 in control group. Thiamin combined with folic acid treatment also resulted in lower level of serum homocysteine in treatment group compare with control group at week 96 (p < 0.05, secondary outcome). 3 patients and 9 patients died during follow-up period in treatment and control group respectively (p ¼ 0.048). The proportion of adverse events in treatment group was significantly lower than that in control group. Conclusion: Hemodialysis patients with cognitive impairment treated with thiamin and folic acid had a significant improvement in MoCA score.

Vitamin Supplementation and Dementia: A Systematic Review

“…Cognitive scores were assessed using the MoCA test. As well as in the previous trial, participants of the intervention group performed better after 96 weeks of supplementation when compared to the control group (p < 0.001) [49]. It needs to be noted that the participants in this study were undergoing haemodialysis due to end-stage kidney disease [49].…”

“…Regarding B Complex vitamins, we included a total of 14 studies. In total, eight of them compared B Complex vitamins to placebo [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ], five of them compared B Complex vitamins to conventional treatment [ 45 , 46 , 47 , 48 , 49 ], and one compared vitamin B supplementation with vitamin C supplementation [ 50 ].…”

“…The 14 included studies analyzed different B vitamins: vitamin B12 (two studies) [ 43 , 50 ], vitamin B1 (benfothiamine) (one study) [ 40 ], folic acid (five studies) [ 37 , 41 , 45 , 46 , 47 ], and the remaining six trials studied the concomitant use of various B Complex vitamins [ 38 , 39 , 42 , 44 , 48 , 49 ].…”

“…Intervention: Five studies [ 45 , 46 , 47 , 48 , 49 ] compared supplementation of B Complex vitamins with conventional treatment.…”

“…In the trial by Lu R. et al, participants received 90 mg thiamine and 30 mg folic acid daily for 96 weeks [ 49 ];…”