Effects of folic acid and vitamin B complex on serum C-reactive protein and albumin levels in stable hemodialysis patients

ABSTRACT

Objective: Folic acid and vitamin B complex administration in uremic patients has been reported to lower plasma total homocysteine (tHcy) levels, but whether or not this has a beneficial effect on the inflammatory state is not clear.

Methods: We conducted a randomized open labeled study to determine the effects of folic acid (5?mg daily) and vitamin B complex administration on plasma tHcy levels as well as inflammatory (serum high-sensitivity C reactive protein, hs?CRP) and nutritional (serum albumin) markers in patients on maintenance hemodialysis. Treatment was given for 3 consecutive months to 61 patients on maintenance hemodialysis. Another 60 patients, all age-, sex-, hemodialysis duration-matched served as control group.

Main outcome measures: Plasma tHcy, serum hs?CRP, albumin, creatinine (Cr), post-dialysis body weight (BW), and normalized protein catabolism rate (nPCR).

Results: After 3 months, levels of plasma tHcy and serum hs?CRP, Cr, and nPCR were significantly decreased while levels of serum albumin, vitamin B₁₂, folate, and BW were significantly increased. The dialytic dose (KT/V) and dietary intake remained unchanged. However, correlations between the magnitude of reduction of tHcy & hs?CRP, tHcy & Cr, and Cr & nPCR were statistically significant.

Conclusions: Folic acid and vitamin B complex co-administration effectively lowers tHcy and hs?CRP levels and increases albumin levels in stable hemodialysis subjects, underscoring their potential benefit to attenuate the state of inflammation and possibly improve the nutritional status in patients on hemodialysis.