Micronutrient supplementation in haemodialysis patients enhances folate levels and reduces homocysteine

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

.Background: End stage renal disease is associated with an increase in oxidative stress, cardiovascular disease and cancer. The main treatment for this condition is haemodialysis (HD), which itself induces repetitive bouts of oxidative stress through membrane biocompatibility and endotoxin challenge. Micronutrient supplementation has been found to have a beneficial effect on oxidative stress levels in HD patients. However, few long term studies of nutritional supplements containing both folic acid and antioxidant vitamins at physiological and not pharmacological levels have been undertaken. The aim of this investigation was to examine the effect of a micronutrient supplement (containing folic acid, B vitamins, antioxidant vitamins and trace elements) on folate and homocysteine (tHcy) levels in HD patients.Materials and methods: Ethical permission was obtained from the ORECNI and Governance was obtained from the WHSCT. Forty established haemodialysis patients gave informed consent and were then randomised (double blind) to receive daily either a placebo or treatment capsule. Blood sample were collected and processed at baseline and 12 months to measure tHcy using an immunoassay(1), plasma folate and whole blood folate were measured by a microbiological assay (2) .Results: 37 volunteers completed the intervention one patient died and two had transplants. We report a significant increase in plasma folate (5.61 ± 3.6 vs 23.39 ± 9.84ng/ml; P>0.0001) and whole blood folate (144.04 ± 80.55 vs 341.61 ± 250.11 ng/ml; P>0.002) and a significant reduction in tHcy (25.73.± 9.48 vs 19.74 ±4.3mol/l (P>0.05), equating to a 31% reduction. Conclusion: The significant increase observed in the folate measurements together with the significant reduction in tHcy support the need for micronutrient supplementation among haemodialysis patients. By lowering tHcy levels and increasing folate it is proposed that patients will be better protected against cardiovascular complications and the oxidative stress that accompanies their treatment regimes.
LanguageEnglish
Title of host publicationUnknown Host Publication
Number of pages1
Publication statusPublished - 2012
Event4th Annual Translational Medicine Conference - City Hotel, Derry/Londonderry, Northern Ireland
Duration: 1 Jan 2012 → …

Conference

Conference4th Annual Translational Medicine Conference
Period1/01/12 → …

Fingerprint

Micronutrients
Homocysteine
Folic Acid
Renal Dialysis
Oxidative Stress
Vitamins
Antioxidants
Vitamin B Complex
Trace Elements
Informed Consent
Immunoassay
Endotoxins
Chronic Kidney Failure
Capsules
Volunteers
Cardiovascular Diseases
Therapeutics
Placebos
Pharmacology
Transplants

Cite this

@inproceedings{da80a2783468468490afbc159b48fe08,
title = "Micronutrient supplementation in haemodialysis patients enhances folate levels and reduces homocysteine",
abstract = ".Background: End stage renal disease is associated with an increase in oxidative stress, cardiovascular disease and cancer. The main treatment for this condition is haemodialysis (HD), which itself induces repetitive bouts of oxidative stress through membrane biocompatibility and endotoxin challenge. Micronutrient supplementation has been found to have a beneficial effect on oxidative stress levels in HD patients. However, few long term studies of nutritional supplements containing both folic acid and antioxidant vitamins at physiological and not pharmacological levels have been undertaken. The aim of this investigation was to examine the effect of a micronutrient supplement (containing folic acid, B vitamins, antioxidant vitamins and trace elements) on folate and homocysteine (tHcy) levels in HD patients.Materials and methods: Ethical permission was obtained from the ORECNI and Governance was obtained from the WHSCT. Forty established haemodialysis patients gave informed consent and were then randomised (double blind) to receive daily either a placebo or treatment capsule. Blood sample were collected and processed at baseline and 12 months to measure tHcy using an immunoassay(1), plasma folate and whole blood folate were measured by a microbiological assay (2) .Results: 37 volunteers completed the intervention one patient died and two had transplants. We report a significant increase in plasma folate (5.61 ± 3.6 vs 23.39 ± 9.84ng/ml; P>0.0001) and whole blood folate (144.04 ± 80.55 vs 341.61 ± 250.11 ng/ml; P>0.002) and a significant reduction in tHcy (25.73.± 9.48 vs 19.74 ±4.3mol/l (P>0.05), equating to a 31{\%} reduction. Conclusion: The significant increase observed in the folate measurements together with the significant reduction in tHcy support the need for micronutrient supplementation among haemodialysis patients. By lowering tHcy levels and increasing folate it is proposed that patients will be better protected against cardiovascular complications and the oxidative stress that accompanies their treatment regimes.",
author = "Hannon-Fletcher, {Mary P.A}",
note = "Reference text: 1. Leino A. Fully automated measurement of total homocysteine in plasma and serum on the Abbott IMX analyzer. Clin Chem 1999; 45: 569-571 2. Molloy AM & Scott JM. Microbiological assay for serum, plasma and red cell folate using cryopreserved, microtiter plate method. Methods enzymol 1997; 281: 43-53",
year = "2012",
language = "English",
booktitle = "Unknown Host Publication",

}

Hannon-Fletcher, MPA 2012, Micronutrient supplementation in haemodialysis patients enhances folate levels and reduces homocysteine. in Unknown Host Publication. 4th Annual Translational Medicine Conference, 1/01/12.

Micronutrient supplementation in haemodialysis patients enhances folate levels and reduces homocysteine. / Hannon-Fletcher, Mary P.A.

Unknown Host Publication. 2012.

Research output: Chapter in Book/Report/Conference proceedingConference contribution

TY - GEN

T1 - Micronutrient supplementation in haemodialysis patients enhances folate levels and reduces homocysteine

AU - Hannon-Fletcher, Mary P.A

N1 - Reference text: 1. Leino A. Fully automated measurement of total homocysteine in plasma and serum on the Abbott IMX analyzer. Clin Chem 1999; 45: 569-571 2. Molloy AM & Scott JM. Microbiological assay for serum, plasma and red cell folate using cryopreserved, microtiter plate method. Methods enzymol 1997; 281: 43-53

PY - 2012

Y1 - 2012

N2 - .Background: End stage renal disease is associated with an increase in oxidative stress, cardiovascular disease and cancer. The main treatment for this condition is haemodialysis (HD), which itself induces repetitive bouts of oxidative stress through membrane biocompatibility and endotoxin challenge. Micronutrient supplementation has been found to have a beneficial effect on oxidative stress levels in HD patients. However, few long term studies of nutritional supplements containing both folic acid and antioxidant vitamins at physiological and not pharmacological levels have been undertaken. The aim of this investigation was to examine the effect of a micronutrient supplement (containing folic acid, B vitamins, antioxidant vitamins and trace elements) on folate and homocysteine (tHcy) levels in HD patients.Materials and methods: Ethical permission was obtained from the ORECNI and Governance was obtained from the WHSCT. Forty established haemodialysis patients gave informed consent and were then randomised (double blind) to receive daily either a placebo or treatment capsule. Blood sample were collected and processed at baseline and 12 months to measure tHcy using an immunoassay(1), plasma folate and whole blood folate were measured by a microbiological assay (2) .Results: 37 volunteers completed the intervention one patient died and two had transplants. We report a significant increase in plasma folate (5.61 ± 3.6 vs 23.39 ± 9.84ng/ml; P>0.0001) and whole blood folate (144.04 ± 80.55 vs 341.61 ± 250.11 ng/ml; P>0.002) and a significant reduction in tHcy (25.73.± 9.48 vs 19.74 ±4.3mol/l (P>0.05), equating to a 31% reduction. Conclusion: The significant increase observed in the folate measurements together with the significant reduction in tHcy support the need for micronutrient supplementation among haemodialysis patients. By lowering tHcy levels and increasing folate it is proposed that patients will be better protected against cardiovascular complications and the oxidative stress that accompanies their treatment regimes.

AB - .Background: End stage renal disease is associated with an increase in oxidative stress, cardiovascular disease and cancer. The main treatment for this condition is haemodialysis (HD), which itself induces repetitive bouts of oxidative stress through membrane biocompatibility and endotoxin challenge. Micronutrient supplementation has been found to have a beneficial effect on oxidative stress levels in HD patients. However, few long term studies of nutritional supplements containing both folic acid and antioxidant vitamins at physiological and not pharmacological levels have been undertaken. The aim of this investigation was to examine the effect of a micronutrient supplement (containing folic acid, B vitamins, antioxidant vitamins and trace elements) on folate and homocysteine (tHcy) levels in HD patients.Materials and methods: Ethical permission was obtained from the ORECNI and Governance was obtained from the WHSCT. Forty established haemodialysis patients gave informed consent and were then randomised (double blind) to receive daily either a placebo or treatment capsule. Blood sample were collected and processed at baseline and 12 months to measure tHcy using an immunoassay(1), plasma folate and whole blood folate were measured by a microbiological assay (2) .Results: 37 volunteers completed the intervention one patient died and two had transplants. We report a significant increase in plasma folate (5.61 ± 3.6 vs 23.39 ± 9.84ng/ml; P>0.0001) and whole blood folate (144.04 ± 80.55 vs 341.61 ± 250.11 ng/ml; P>0.002) and a significant reduction in tHcy (25.73.± 9.48 vs 19.74 ±4.3mol/l (P>0.05), equating to a 31% reduction. Conclusion: The significant increase observed in the folate measurements together with the significant reduction in tHcy support the need for micronutrient supplementation among haemodialysis patients. By lowering tHcy levels and increasing folate it is proposed that patients will be better protected against cardiovascular complications and the oxidative stress that accompanies their treatment regimes.

M3 - Conference contribution

BT - Unknown Host Publication

ER -