The link between homocysteine, folic acid and vitamin B12 in chronic kidney disease.
G Ital Nefrol
; 38(4)2021 Aug 30.
Article
en En
| MEDLINE
| ID: mdl-34469084
ABSTRACT
Patients with chronic kidney disease or end-stage renal disease experience tremendous cardiovascular risk. Cardiovascular events are the leading causes of death in these patient populations, thus the interest in non-traditional risk factors such as hyperhomocysteinemia, folic acid and vitamin B12 metabolism is growing. Hyperhomocysteinemia is commonly found in CKD patients because of impaired renal metabolism and reduced renal excretion. Folic acid, the synthetic form of vitamin B9, is critical in the conversion of homocysteine to methionine like vitamin B12. Folic acid has also been shown to improve endothelial function without lowering homocysteine, suggesting an alternative explanation for the effect of folic acid on endothelial function. Whether hyperhomocysteinemia represents a reliable marker of cardiovascular risk and cardiovascular mortality or a therapeutic target in this population remains unclear. However, it is reasonable to consider folic acid with or without methylcobalamin supplementation as appropriate adjunctive therapy in patients with CKD. The purpose of this review is to summarize the characteristics of homocysteine, folic acid, and vitamin B12 metabolism, the mechanism of vascular damage, and the outcome of vitamin supplementation on hyperhomocysteinemia in patients with CKD, ESRD, dialysis treatment, and in kidney transplant recipients.
Palabras clave
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Hiperhomocisteinemia
/
Fallo Renal Crónico
Tipo de estudio:
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
G Ital Nefrol
Asunto de la revista:
NEFROLOGIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Italia