Effect of withdrawal of folic acid supplementation in maintenance hemodialysis patients.

The requirement of patients on maintenance hemodialysis for dietary supplements of folic acid is controversial. High levels of folate carry the risk of toxicity as well as being unnecessary. We followed a group of 41 patients, not receiving erythropoietin, for 16 months after the cessation of folate supplementation (5 mg/day). Diet supplied 60-80 g protein and 120-260 μg folic acid/day. Red cell folate levels decreased linearly from a mean of 1931±888 μg/l (±SD) to 676±294 μg/l after 6 months before levelling off at 455±222 μg/l after 9 months. Mean values were unchanged 7 months later (491±319 μg/l). No patient developed folate deficiency