Related Experiment Video

Updated: Aug 15, 2026

A Murine Model of Hemodialysis Access-Related Hand Dysfunction
08:39

A Murine Model of Hemodialysis Access-Related Hand Dysfunction

Published on: May 31, 2022

Young hemodialysis patients are exposed to hyperhomocysteinemia

Tsuneo Takenaka1, Yoshiaki Itaya, Hiromichi Suzuki

  • 1Shinjuku Suimei Clinic, Shinjuku, Tokyo, Japan.

Journal of Renal Nutrition : the Official Journal of the Council on Renal Nutrition of the National Kidney Foundation
|October 4, 2005
PubMed

Insights

High homocysteine levels are common in hemodialysis patients. Folic acid treatment reduced homocysteine and halted pulse wave velocity increases in younger patients, suggesting a potential cardiovascular benefit.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Clinical Nutrition

Background:

  • Cardiovascular disease is a major complication in patients undergoing hemodialysis (HD).
  • Elevated plasma total homocysteine (tHcy) is a recognized risk factor for cardiovascular events in HD populations.
  • Pulse wave velocity (PWV) is a marker of arterial stiffness and a predictor of cardiovascular risk.

Purpose of the Study:

  • To investigate the relationship between homocysteine levels and cardiovascular risk factors in hemodialysis patients.
  • To assess the impact of folic acid supplementation on pulse wave velocity (PWV) in patients on maintenance hemodialysis.

Main Methods:

  • A cross-sectional study measured plasma tHcy in 49 HD patients.
  • A prospective study followed 10 younger HD patients (<45 years) to evaluate monthly changes in PWV before and during folic acid treatment (10-20 mg/d).
  • Blood pressure, lipids, calcium, phosphate, parathormone, and tHcy levels were monitored.

Main Results:

  • Younger HD patients exhibited higher tHcy levels.
  • Patients with myocardial ischemia had significantly higher tHcy compared to those without.
  • Folic acid treatment led to a significant reduction in tHcy levels (46 +/- 5 to 27 +/- 3 nmol/mL).
  • Progressive increases in PWV were halted during folic acid treatment (33 +/- 8 to 3 +/- 6 cm/sec/month).
  • Folic acid did not alter blood pressure or other biochemical parameters.

Conclusions:

  • Young and middle-age hemodialysis patients often experience severe hyperhomocysteinemia.
  • High-dose folic acid supplementation may attenuate the progression of arterial stiffness, as indicated by PWV, in HD patients.
  • Folic acid's potential role in managing cardiovascular risk in HD patients warrants further investigation.
Abstract

Related Concept Videos

Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...
Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis01:30

Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis

Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...