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Study of the homocysteine status in children with chronic renal failure

Farida A Farid1, Mohamed S Faheem, Nahla M Heshmat

  • 1Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt. nahla_heshmat@hotmail.com

American Journal of Nephrology
|April 17, 2004
PubMed

Insights

Children with chronic renal failure (CRF) on hemodialysis have high homocysteine (Hcy) levels. Combined folic acid and vitamin B12 therapy effectively reduces Hcy to normal levels in these pediatric patients.

Area of Science:

  • Nephrology
  • Vascular Biology
  • Nutritional Science

Background:

  • Vascular diseases are a significant cause of mortality in end-stage renal disease (ESRD) patients.
  • Hyperhomocysteinemia is a potential risk factor for accelerated atherosclerosis and thrombosis in ESRD.
  • Homocysteine (Hcy) may induce endothelial cell injury, contributing to vascular complications.

Purpose of the Study:

  • To evaluate homocysteine (Hcy) status in children with chronic renal failure (CRF), particularly those with ESRD.
  • To assess the efficacy of folic acid and vitamin B12 therapy in correcting hyperhomocysteinemia in pediatric CRF patients.

Main Methods:

  • Study included 40 CRF children (30 on hemodialysis, 10 on conservative treatment) and 20 controls.
  • Measured serum Hcy, folic acid, vitamin B12, and plasma activated protein C resistance (APC-R).
  • Intervention involved folic acid and/or vitamin B12 therapy in hemodialysis patients.

Main Results:

  • Serum Hcy levels were significantly higher in hemodialysis patients compared to conservative treatment and controls.
  • No significant differences were observed in APC-R, folic acid, or vitamin B12 levels among groups.
  • Combined folic acid and vitamin B12 therapy significantly reduced Hcy levels in hemodialysis patients.

Conclusions:

  • Children with ESRD undergoing regular hemodialysis exhibit elevated homocysteine (Hcy) levels.
  • Combined therapy with the active form of folic acid and vitamin B12 effectively lowers Hcy in these children.
  • This combined therapy normalizes Hcy levels to those observed in healthy controls.
Abstract

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