The effect of vitamin B6 and folate supplements on plasma homocysteine and serum lipids levels in patients on regular hemodialysis.

Background: Hyperhomocysteinemia is anindependent risk factor for cardiovascularevents. The aim of this study was to show theresults of the reduction of homocysteine in endstage renal failure patients on hemodialysis,as it is known, have higher levels ofhomocysteine than other groups of subjects.Methods: Plasma homocysteineconcentration was determined before and afterthe administration of vitamin B6 and folicacid in 12 patients (males : 6) on regulardialysis therapy. Mean monthly fasting serumconcentrations of total cholesterol (TCHOL),HDL-chol, LDL-chol and triglycerides (TRG) weredetermined for a period 68 months (12–120months) before and 26 months after theadministration of vitamin B6 and folicacid. Results: Mean serum concentrations forfolic acid and vitamin B12 before andafter the administration were: folic acid:5.03 ± 4.9 and 18.0 ± 19.2 ng/ml,(p < 0.0001) and B12 : 456 ± 257 and514.38 ± 307 pg/mL respectively). Plasmahomocysteine was reduced significantly afterthe administration of above drugs (from47 ± 14 to 29 ± 9 µmol/mL, p < 0.001).This reduction of homocysteine resulted in amodification of the patients' lipidemicprofile: Serum LDL-chol was decreasedsignificantly (119 ± 38 mg/dL to110 ± 35 mg/dL, p<0.005). TCHOL and TRG werealso decreased but not significantly(190 ± 45 mg/dL to 187 ± 43 mg/dL and116 ± 63 mg/dL to 108 ± 47 mg/dLrespectively)). Serum concentrations HDL-cholwere increased significantly (from42 ± 10 mg/dL to 47 ± 10 mg/dL, p < 0.001).The atherogenic index for cholesterol, LDL/HDL,was 1.6 times lower after the drugs receiving(before: LDL/HDL = 3.1 and after: LDL/HDL = 2.5,p < 0.001).Conclusions: These results indicate thatthe folate and vitamin B6 supplementationresulted in reduction of homocysteine levelsand improvement of lipidemic profile in regulardialysis patients.