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Related Experiment Videos

Do dialysis patients need extra folate supplementation?

E Y Lee1, J S Kim, H J Lee

  • 1Department of Internal Medicine, Yonsei University, Wonja College of Medicine, Korea.

Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis
|February 22, 2000
PubMed
Summary

Folate deficiency is surprisingly low in dialysis patients, even without supplementation. Red cell folate levels are essential for assessing folate status before considering supplementation for end-stage renal disease patients.

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Area of Science:

  • Nephrology
  • Clinical Nutrition
  • Biochemistry

Background:

  • Patients with end-stage renal disease (ESRD) on dialysis often have altered nutritional status.
  • Folate status is critical for overall health, and supplementation is common, but its necessity in dialysis patients requires evaluation.

Purpose of the Study:

  • To assess folate status in continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) patients.
  • To evaluate the necessity of conventional folate supplementation in these patient populations.

Main Methods:

  • Radioimmunoassay was used to measure serum folate, vitamin B12, and red cell folate concentrations.
  • Thirty-four CAPD patients and 60 HD patients not receiving folate supplements were enrolled.

Main Results:

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  • CAPD patients had significantly higher serum folate, vitamin B12, and red cell folate levels compared to HD patients.
  • Using serum folate cut-offs overestimated folate deficiency (3.0% CAPD vs. 71.7% HD).
  • Red cell folate levels indicated a lower incidence of true folate deficiency (0.0% CAPD vs. 10.0% HD).

Conclusions:

  • The true incidence of folate deficiency in stable CAPD and HD patients is low.
  • The need for routine folate supplementation in dialysis patients should be re-evaluated.
  • Measuring red cell folate is crucial to assess folate reserves before initiating supplementation in dialysis patients.