Homocysteine, fibrinogen, and lipoprotein(a) levels are simultaneously reduced in patients with chronic renal failure treated with folic acid, pyridoxine, and cyanocobalamin

Ischemic heart disease and other complications of atherosclerosis are the u sual cause of death in patients with chronic renal failure. Important facto rs associated with early onset of atherosclerosis in these patients are hyp erhomocysteinemia, hyperfibrinogenemia, and elevated levels of lipoprotein( a) (Lp(a)), Folic acid (15 mg/d), pyridoxine (150 mg/d), and cyanocobalamin (1 mg/wk) were administered for 4 weeks in 21 patients receiving dialysis, and a simultaneous, statistically significant reduction in the concentrati on of homocysteine. fibrinogen, and Lp(a) was found. A positive correlation between decreasing homocysteine and fibrinogen levels was also noted. The parameters studied approached presupplementation values 6 months after vita mins were discontinued, The results suggest that vitamin supplementation ha s a favorable effect on risk factors of atherosclerosis in patients with re nal failure and that interactions may exist between homocysteine, fibrinoge n, and Lp(a). Copyright (C) 2001 by W.B. Saunders Company.