Comparative effects of hydroxocobalamin and cyanocobalamin on plasma homocysteine concentrations in end-stage renal disease

Hoffer, L. John; Djahangirian, Orchidée; Bourgouin, P.; Eid, Johana; Saboohi, Farhad

doi:10.1016/j.metabol.2005.04.027

Cited by 9 publications

(9 citation statements)

References 42 publications

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“…[26] Hoffer et al also found that it was the dosage rather than the dosage form that influenced the potency of Vit B12 on tHcy-lowering. [14] The degree of Hcy decrease of up to 29.3% in our Vit B12 group was similar to that of the 30% decrease by folic acid supplement in many other studies. However, there are no reports with similar effects of Vit B12 on Hcy levels.…”

Section: Discussionsupporting

confidence: 91%

“…[13,14,16] Up to a 60% reduction of Hcy had been reported when pharmacologic Vit B12 was given after every dialysis. [23] Therefore, it seems the maximal effect of pharmacologic dose of Vit B12 on Hcy-lowering could be achieved with the simultaneous supplement of folic acid.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13] Pharmacological dose of Vit B12, in combination with folic acid, has been reported to be effective in lowering the plasma Hcy levels. [13][14][15][16] However, the effect of pharmacologic does of Vit B12 alone was not clear. Folic acid supplement with dose as low as 1.1mg/week, even in combination with pharmacologic dose of Vit B12, had no effect on hyperhomocysteinemia correction.…”

Section: Introductionmentioning

confidence: 99%

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Pharmacological Dose of Vitamin B12 Is as Effective as Low-Dose Folinic Acid in Correcting Hyperhomocysteinemia of Hemodialysis Patients

et al. 2009

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Various regimens of folic acid-based and vitamin B12 (Vit B12) supplementations have been tried for lowering plasma homocysteine (Hcy) levels in uremic patients. However, the therapeutic potency of low-dose folic acid and Vit B12 alone is not properly understood. In this study, seventy-five patients on chronic hemodialysis (HD) therapy were randomized into three groups. The FNA group received intravenous (IV) supplementation with folinic acid 3 mg weekly; the Vit B12 group received IV supplementation with vitamin B12 1 mg weekly; and the combination group received IV supplementation with both agents weekly. Blood levels of Hcy, folic acid, and Vit B12 were measured monthly for three months. After three months of treatment, plasma levels of Hcy decreased significantly in all three groups when compared with their baselines (all p < 0.05). The final Hcy level was significantly lower in the combination group (11.5 ± 2.3 μmol/L) when compared with that of the FNA group (15.9 ± 5.6 μmol/L, p < 0.05) but not with the Vit B12 group (15.9 ± 11.6 μmol/L), although their baseline levels were similar. The percentage decreases of tHcy at the end of the treatment in the FNA group, Vit B12 group, and combination group were 16.4%, 29.3%, and 38.9% respectively. Our study showed that IV pharmacologic dose of Vit B12 alone is as effective as low-dose folic acid in correcting hyperhomocysteinemia in chronic HD patients, and combining both drugs in low doses may have added effects.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pharmacological Dose of Vitamin B12 Is as Effective as Low-Dose Folinic Acid in Correcting Hyperhomocysteinemia of Hemodialysis Patients

et al. 2009

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“…The B‐vitamin infusion consisted of 1mg cobalamin (vitamin B 12 ) and 5 mg folic acid diluted in 250 ml normal saline. We used drug doses similar to those that have been used successfully to lower plasma total homocysteine in renal dialysis patients [10, 11]. The infusion bag was wrapped in aluminium foil to prevent accidental disclosure of the group assignment due to the pink colour of cobalamin.…”

Section: Methodsmentioning

confidence: 99%

Pre‐operative vitamin B infusion and prevention of nitrous oxide‐induced homocysteine increase

Rao

Francis²,

Wilcox³

et al. 2010

Anaesthesia

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Summary Nitrous oxide inactivates vitamin B12 with detrimental consequences for folate and methionine metabolism. This inactivation can be clinically detected by an increase in plasma total homocysteine. In a clinical trial, we tested the hypothesis that a preoperative infusion of vitamin B12 and folate prevents the nitrous oxide-induced homocysteine increase. Sixty-three healthy patients scheduled for elective surgery were randomly allocated to receive (a) B-vitamins and nitrous oxide; (b) placebo and nitrous oxide or (c) normal saline and no nitrous oxide. Fifty-nine patients were included in the final study population. After intravenous B-vitamin infusion, plasma vitamin B12 and folate concentrations increased 35-fold and 12-fold on the first postoperative measurement, respectively. Patients who received B-vitamins developed a similar increase (+18%) in homocysteine after nitrous oxide (+ 1.9 μmol.L−1; 95% CI: 0.2 – 3.6 μmol.L−1) as patients who did not receive B-vitamins (+ 22%; + 2.7 μmol/L; 95% CI: 0.6 – 4.8 μmol.L−1). Patients who did not receive nitrous oxide (“air control”) had no change in homocysteine (+ 0.5 μmol.L−1; 95% CI: −0.8 – 1.9 μmol.L−1). This trial indicates that preoperative IV B-vitamins may not prevent nitrous oxide-induced hyperhomocysteinemia.

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“…Our study is the first to examine intramuscular hydroxocobalamin supplementation in HD patients with serum B12 levels below 300 pmol/L. Previous observational and randomized controlled trials adding parenteral methylcobalamin, hydroxocobalamin or cyanocobalamin to oral folic acid supplements in HD patients have demonstrated normalization of hyperhomocysteinemia and decreased asymmetric dimethylarginine (ADMA) levels and arterial stiffness . A short study examining the effect of parenteral cyanocobalamin over 12 weeks in HD patients showed a reduction in MMA levels without effect on haemoglobin or ESA dosages .…”

Section: Discussionmentioning

confidence: 84%

Hydroxocobalamin supplementation and erythropoisis stimulating agent hyporesponsiveness in haemodialysis patients

Killen

Brenninger

2014

Nephrology

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In HD patients with B12 < 300 pmol/L, following treatment with hydroxocobalamin there was reduced erythropoietin requirements, maintained Hb and a small but significant rise in the serum albumin. RCF may be low in haemodialysis patients with metabolic cobalamin deficiency and rises significantly after supplementation. Hydroxocobalamin supplementation may have the potential to reduce the cost of anaemia management.

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Comparative effects of hydroxocobalamin and cyanocobalamin on plasma homocysteine concentrations in end-stage renal disease

Cited by 9 publications

References 42 publications

Pharmacological Dose of Vitamin B12 Is as Effective as Low-Dose Folinic Acid in Correcting Hyperhomocysteinemia of Hemodialysis Patients

Pharmacological Dose of Vitamin B12 Is as Effective as Low-Dose Folinic Acid in Correcting Hyperhomocysteinemia of Hemodialysis Patients

Pre‐operative vitamin B infusion and prevention of nitrous oxide‐induced homocysteine increase

Hydroxocobalamin supplementation and erythropoisis stimulating agent hyporesponsiveness in haemodialysis patients

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