EFFECT OF WITHDRAWAL OF FOLIC-ACID SUPPLEMENTATION IN MAINTENANCE HEMODIALYSIS-PATIENTS

The requirement of patients on maintenance hemodialysis for dietary su pplements of folic acid is controversial. High levels of folate carry the risk of toxicity as well as being unnecessary. We followed a group of 41 patients, not receiving erythropoietin, for 16 months after the cessation of folate supplementation (5 mg/day). Diet supplied 60-80 g protein and 120-260 mug folic acid/day. Red cell folate levels decrea sed linearly from a mean of 1931 +/- 888 mug/l (+/- SD) to 676 +/- 294 mug/l after 6 months before levelling off at 455 +/- 222 mug/l after 9 months. Mean values were unchanged 7 months later (491 +/- 319 mug/l ). No patient developed folate deficiency. Hemoglobin values at 6, 9 a nd 16 months were slightly higher than the baseline value of 8.3 +/- 1 .8 g/dl (p <0.05). Mean corpuscular volumes were generally within norm al limits, and vitamin B-12 status was satisfactory. We conclude that folic acid supplements are unnecessary in adequately nourished hemodia lysis patients who are not receiving erythropoietin.