Reduction of plasma homocysteine by folic acid in children with chronic renal failure

Kang, Hee Gyung; Lee, Byong Sop; Hahn, Hyewon; Lee, Jun Ho; Ha, Il Soo; Cheong, Hae Il; Choi, Yong

doi:10.1007/s00467-002-0864-8

Cited by 13 publications

(8 citation statements)

References 22 publications

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“…Similar results were also reported in children with CRF [19,20,21,22]. Some hypotheses have been suggested for hyperhomocysteinemia in CRF.…”

Section: Discussionsupporting

confidence: 90%

“…The plasma vitamin B 12 level can also affect the plasma homocysteine level and hyperhomocysteinemia can persist in patients despite normal to supranormal levels of vitamin B 12 . Routine folate and vitamin B 12 supplementation has been recommended in patients with CRF [6,21,27]. In our study, median plasma folate and vitamin B 12 concentrations in the CRF group were lower than in the control group, but the difference was not statistically significant.…”

Section: Discussioncontrasting

confidence: 77%

“…These findings are compatible with previous studies and support previous observations that plasma homocysteine levels increase gradually with the deterioration of renal function. The mean plasma homocysteine level in our CRF group was similar to that reported by Kang et al [21] and lower than that of Lilien et al [19] and Merouani et al [20]. These differences may be related to the different methods of measurement or different characteristics of the study populations, such as nutritional status and medication.…”

Section: Discussionsupporting

confidence: 71%

“…There is a strong inverse relationship between the plasma homocysteine concentration and plasma folate levels both in normal individuals and patients with CRF [20,21,26]. The plasma vitamin B 12 level can also affect the plasma homocysteine level and hyperhomocysteinemia can persist in patients despite normal to supranormal levels of vitamin B 12 .…”

Section: Discussionmentioning

confidence: 96%

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Homocysteine and left ventricular hypertrophy in children with chronic renal failure

Poyrazoğlu

Düşünsel

Narin

et al. 2004

Pediatric Nephrology

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Hyperhomocysteinemia is recognized as an independent risk factor for cardiovascular disease, especially atherosclerosis, in adult patients with chronic renal failure (CRF). However, there is little information about the relationship between plasma homocysteine levels and left ventricular hypertrophy. The aim of this study was to determine plasma homocysteine levels and risk factors for left ventricular hypertrophy and to investigate the relationship between plasma homocysteine concentration and left ventricular mass index (LVMI) in children with CRF. The homocysteine level was measured by high-performance liquid chromatography and LVMI was calculated using echocardiographic findings in 27 children with CRF and 16 healthy controls. The mean LVMI and mean plasma homocysteine concentration in the CRF group, especially in patients with end-stage renal disease, were statistically higher than the control group ( P<0.05). There was no correlation between LVMI and plasma homocysteine concentration. There was a positive correlation between plasma homocysteine concentration and serum creatinine level. There was a positive correlation of LVMI with creatinine and blood pressures (systolic, diastolic, and mean arterial pressure). There was a negative correlation of LVMI with hemoglobin level in multiple linear regression analysis. In our view homocysteine does not have a direct effect on left ventricular structure and left ventricular hypertrophy is the end organ damage associated with hypertension, anemia, and CRF. More prospective studies are needed to better clarify the inter-relationships of plasma homocysteine level and left ventricular structure in children with CRF.

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“…Similar results were also reported in children with CRF [19,20,21,22]. Some hypotheses have been suggested for hyperhomocysteinemia in CRF.…”

Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 77%

Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 96%

See 2 more Smart Citations

Homocysteine and left ventricular hypertrophy in children with chronic renal failure

Poyrazoğlu

Düşünsel

Narin

et al. 2004

Pediatric Nephrology

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“…In addition, pre-folate homocysteine, an established cardiovascular risk factor in the nonrenal population, was higher in FD than in the non-FD subjects, reflecting the common finding of hyperhomocysteinemia in FD states (Table 4) [25,34,35,36].…”

Section: Diagnostic Indicesmentioning

confidence: 99%

Role of folate deficiency on erythropoietin resistance in pediatric and adolescent patients on chronic dialysis

Bamgbola

Kaskel

2005

Pediatr Nephrol

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Unlike iron therapy, folate use is not a standard of care in hemodialysis (HD) patients. Despite iron repletion, poor response to erythropoietin (EPO) treatment is common. Theoretical evidence for folate deficiency (FD) includes chronic blood loss, inflammation, malnutrition, and nutrient loss during dialysis. Due to poor diagnostic standards, early studies failed to establish a role for FD in EPO resistance. Given that hematological response to therapeutic intervention is the gold standard for FD, its diagnosis was therefore based on composite scoring of RBC and/or folate indices. Fifteen subjects (8-20 years) on chronic HD were enrolled in this study. No folate supplement was given in the first six months. Thereafter, 5-mg folic acid was administered orally after HD sessions over a six-month period. Folate indices before and after treatment were compared using percentage differences and paired t-tests. After folate use, the mean Hb increased by 11.4%, while MCV and RDW were reduced. Similarly, 4 of the 15 subjects each had a > or = 20% rise in Hb and a > or = 5% reduction in MCV, while 46.7% had a > or = 2.5% reduction in RDW. Mean RBC folate increased by 24%, while FD scores reduced from 3.8+/-1.2 to 0.4+/-0.7, and the EPO requirement by 90%. In contrast to previous studies, 26.7% of study subjects met the criteria for FD. Furthermore, the substantial (post-folate) reduction in the EPO requirement validates the need for therapeutic intervention, and therefore the presence of functional FD in the population.

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Neurocognitive outcomes in children with chronic kidney disease: Current findings and contemporary endeavors

Gerson

Butler

Moxey-Mims

et al. 2006

Ment. Retard. Dev. Disabil. Res. Rev.

124

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Given the rise in chronic kidney disease (CKD) in both children and adults, CKD has recently been targeted as a public health priority. Childhood onset kidney disease is generally a noncurable and progressive condition that leads to kidney failure by early adulthood. Fortunately, improved identification of kidney problems allows for early intervention, which is thought to slow progression toward end-stage renal disease. In addition, medical interventions for pediatric end-stage renal disease have also improved, allowing children to take advantage of lifesaving renal replacement treatments such as dialysis and kidney transplantation. In spite of improvements in identification and treatment, CKD causes both direct and indirect insults to a variety of organ systems. This paper reviews recently published studies pertaining to the neurocognitive and psychosocial impact of CKD on children of various ages and at various stages of kidney failure. Specific attention is focused on summarizing peer reviewed research that describes associations between kidney functioning and cognitive functioning, language acquisition, visual spatial abilities, memory, and executive functioning. In addition, peer reviewed research describing psychosocial outcomes associated with CKD related to academic achievement, social-behavioral functioning, and quality of life are summarized. The authors also identified disease-specific factors that likely mediate neurocognitive outcomes (e.g., anemia, hypertension, cardiovascular) and endorse the importance of continued interdisciplinary research collaborations that will provide a better understanding of the mechanisms responsible for improved neurocognitive functioning after transplantation. The authors conclude this review by describing a multicenter, prospective, longitudinal, National Institutes of Health funded study that is currently examining the developmental outcomes of children with mild to moderate CKD. The authors speculate that the Chronic Kidney Disease in Children Prospective Cohort Study (CKiD) findings will provide additional evidence-based guidance for clinicians and researchers working with children and adolescents with deteriorating kidney function to improve medical and developmental outcomes.

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Reduction of plasma homocysteine by folic acid in children with chronic renal failure

Cited by 13 publications

References 22 publications

Homocysteine and left ventricular hypertrophy in children with chronic renal failure

Homocysteine and left ventricular hypertrophy in children with chronic renal failure

Role of folate deficiency on erythropoietin resistance in pediatric and adolescent patients on chronic dialysis

Neurocognitive outcomes in children with chronic kidney disease: Current findings and contemporary endeavors

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