Serum Folate and Vitamine B12 Levels in Acute and Chronic Renal Disease. Effect of Peritoneal Dialysis

Markedly Increased Vitamin B12 Concentrations Attributable to IgG–IgM–Vitamin B12 Immune Complexes

“…In this case patient, however, the high vitamin B 12 concentrations should not be caused by increased HC synthesis and release from myeloid cells, because the leukocyte count and differential and total HC were within reference intervals, and total TC was only slightly increased. In addition, it is known that renal failure (24,25 ) and hepatic disease (26,27 ) are associated with high vitamin B 12 concentrations. This patient had normal renal and hepatic function.…”

Binding of Folic Acid Activity by Body Fluids

“…The majority of these coincided with albumin. In addition, H ampers et al [4], Sevitt and H offbrand [13], and R etief and H uskisson [12] have discussed the question of the binding of FAA in their papers on renal and hepatic diseases. M etz and H erbert [10] mentioned unsuccessful attempts to demonstrate binders for folic acid in normal human serum, analogous to those present for vitamin B12.…”

Folate Deficiency in Humans

“…The fact that serum folate fell by at least 50% during dialysis of 9 of 10 subjects with chronic renal disease (Sevitt and Hoffbrand, 1969), and by an average of greater than 50% in an additional 15 subjects not reported individually (Whitehead et Ill., 1968), provides further ev\dence against the suggestion of Hines et al (1973) that almost all serum folate in these subjects is firmly bound to a high-affinity binder.…”

“…An additional causative factor for folate deficiency in uremic patients and others subjected to dialysis is loss of folate in the dialysis fluid, reported to be uniforml y significant in 17 patients by Sevitt and Hoffbrand (1969). The fact that serum folate fell by at least 50% during dialysis of 9 of 10 subjects with chronic renal disease (Sevitt and Hoffbrand, 1969), and by an average of greater than 50% in an additional 15 subjects not reported individually (Whitehead et Ill., 1968), provides further ev\dence against the suggestion of Hines et al (1973) that almost all serum folate in these subjects is firmly bound to a high-affinity binder.…”