Soleimani Alireza, Usefzadeh Mojtaba, Mianehsaz Elahe, Foroozanfard Fatemeh, Nikoueinejad Hassan, Moraveji Seyyed Alireza, Nasiri Omid, Rajali Mohsen
Departments of Internal Medicine and Immunology, Kashan University of Medical Sciences, Iran.
Iran J Kidney Dis. 2011 Jan;5(1):45-9.
INTRODUCTION. Hyperhomocysteinemia is common in patients with chronic kidney disease. There is a direct relationship between cardiovascular mortality and increase of blood homocysteine. Folic acid is used as common treatment in such patients. Folinic acid, a shortened form of folic acid, is not affected by inhibitors of dihydrofolate reductase enzyme such as methoterxate. This study was performed to evaluate the effect of oral folinic acid on the blood homocysteine level of hemodialysis patients, in comparison with folic acid. MATERIALS AND METHODS. This clinical trial was performed on 60 hemodialysis patients. The participants were divided into 2 groups to receive either 15 mg of oral folic acid or 15 mg of oral folinic acid, daily. Blood homocysteine levels were measured before dialysis and after the study period. RESULTS. Folic acid and folinic acid decreased the blood homocysteine levels by 33.0% and 28.7%, respectively (P < .001). However, only 3 patients (6.5%) enjoyed a normalized homocysteine level. CONCLUSIONS. Our study showed that both folic and folinic acid decreased the blood homocysteine level and no meaningful difference was observed between them; therefore, we suggest they can be used interchangeably.
引言。高同型半胱氨酸血症在慢性肾病患者中很常见。心血管死亡率与血液中同型半胱氨酸的增加之间存在直接关系。叶酸是这类患者常用的治疗药物。亚叶酸，叶酸的一种缩短形式，不受甲氨蝶呤等二氢叶酸还原酶抑制剂的影响。本研究旨在评估口服亚叶酸与叶酸相比对血液透析患者血液同型半胱氨酸水平的影响。材料与方法。本临床试验对60名血液透析患者进行。参与者被分为两组，每天分别接受15毫克口服叶酸或15毫克口服亚叶酸。在透析前和研究期结束后测量血液同型半胱氨酸水平。结果。叶酸和亚叶酸分别使血液同型半胱氨酸水平降低了33.0%和28.7%（P <.001）。然而，只有3名患者（6.5%）的同型半胱氨酸水平恢复正常。结论。我们的研究表明，叶酸和亚叶酸均可降低血液同型半胱氨酸水平，且二者之间未观察到有意义的差异；因此，我们建议它们可以互换使用。
