 |
|
Homocysteine Lowering and Severe Kidney Disease
|
|
| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
|
|
|
To the Editor: Dr Jamison and colleagues1 described the results of the Homocysteinemia in Kidney and End Stage Renal Disease (HOST) study, a randomized trial of homocysteine lowering and mortality and vascular disease in patients with severe kidney disease. One of the important rationales behind the HOST trial was that patients with severe chronic kidney failure have substantially elevated plasma homocysteine concentrations.2 Folic acid–based treatments are effective in reducing homocysteine levels in patients with kidney disease, but normalization of homocysteine is rare.3 Patients undergoing dialysis who do not use B-vitamin supplements have homocysteine levels of about 30 to 45 µmol/L, and treatment with as little as 1 mg/d reduces this level to about 20 to 25 µmol/L,4-5 the baseline level in the HOST trial.
Although the authors do not mention the frequency of vitamin supplementation, it seems likely that most study participants used vitamin supplements, which often contain 1 mg . . . [Full Text of this Article]
Coen van Guldener, MD
cvguldener@amphia.nl
Department of Internal Medicine
Amphia Hospital
Breda, the Netherlands
RELATED LETTER
Homocysteine Lowering and Severe Kidney Disease—Reply
Rex L. Jamison, Peter D. Guarino, David S. Goldfarb, and Stuart R. Warren
JAMA. 2008;299(3):288.
EXTRACT
| FULL TEXT
RELATED ARTICLE
Effect of Homocysteine Lowering on Mortality and Vascular Disease in Advanced Chronic Kidney Disease and End-stage Renal Disease: A Randomized Controlled Trial
Rex L. Jamison, Pamela Hartigan, James S. Kaufman, David S. Goldfarb, Stuart R. Warren, Peter D. Guarino, J. Michael Gaziano, and For the Veterans Affairs Site Investigators
JAMA. 2007;298(10):1163-1170.
ABSTRACT
| FULL TEXT
|
