Role of folic acid in atherosclerosis after kidney transplant: a double-blind, randomized, placebo-controlled clinical trial

• Published in: Experimental and clinical transplantation 2009-03, Vol.7 (1), p.33-39
• Main Authors: Nafar, Mohsen, Khatami, Fatemeh, Kardavani, Babak, Farjad, Reza, Pour-Reza-Gholi, Fatemeh, Firouzan, Ahmad, Kalantar, Akbar, Farhangi, Soudabeh, Einollahi, Behzad
• Format: Article
• Language: English
• Subjects: Administration, Oral; Adult; Cardiovascular Agents - administration & dosage; Cardiovascular Agents - therapeutic use; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - etiology; Carotid Artery Diseases - prevention & control; Carotid Artery, Common - diagnostic imaging; Carotid Artery, Common - drug effects; Carotid Artery, Internal - diagnostic imaging; Carotid Artery, Internal - drug effects; Double-Blind Method; Female; Folic Acid - administration & dosage; Folic Acid - therapeutic use; Homocysteine - blood; Humans; Kidney Failure, Chronic - surgery; Kidney Transplantation - adverse effects; Male; Middle Aged; Time Factors; Treatment Outcome; Tunica Intima - drug effects; Tunica Media - drug effects; Ultrasonography, Doppler
• ISSN: 1304-0855

We investigated the effects of folic acid supplementation on plasma total homocysteine levels and carotid intima-media thickness after kidney transplant. Sixty patients who had undergone a kidney transplant were studied in this double-blind, randomized, placebo-controlled clinical trial. Those subjects were randomized to receive either 5 mg/d of oral folic acid or an equivalent dosage of placebo. The main outcome variables were the plasma total homocysteine level and carotid intima-media thickness (determined via B-mode sonography) at baseline and 2, 4, and 6 months after kidney transplant. We used independent and paired sample t tests for data analysis. The mean age of the patients was 40.9 -/+ 10 years, and 32 of those subjects (58.2%) were men. In the control group, the plasma total homocysteine levels were 19 micromol/L at baseline, 18.7 micromol/L after 2 months, 19.3 micromol/L after 4 months, and 20 micromol/L after 6 months; and the carotid intima-media thickness measurements were 0.81 mm at baseline, 0.82 mm after 2 months, 0.84 mm after 4 months, and 0.85 mm after 6 months. In the folic acid group, the plasma total homocysteine levels were 18.5 micromol/L at baseline, 4.7 micromol/L after 2 months, 12.9 micromol/L after 4 months, and 10.9 micromol/L after 6 months; and the carotid intima-media thickness measurements were 0.73 mm at baseline, 0.73 mm after 2 months, 0.72 mm after 4 months, and 0.71 mm after 6 months. Folic acid supplementation reduces both the plasma total homocysteine level and carotid intima-media thickness shortly after kidney transplant.