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

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.