A Study on the Levels of Folic Acid, Vitamin B12 and Plasma Homocysteine in Patients with Chronic Kidney Disease

Abstract

Chronic kidney disease (CKD) is defined as abnormalities of kidney structure or function, present for >3 months, with implications for health. Therapeutic interventions at earlier stages can prevent or ameliorate most of the complications of decreased kidney function, as well as slow the progression to kidney failure. Coronary artery disease (CAD) is the most common cause of death in CKD patients. Low serum folic acid, low serum vitamin B12 and high serum homocysteine are commonly associated with CKD.

Material: This work was a single-centre, cross-sectional, descriptive study which included 100 patients who met the criteria for CKD, as per KDIGO guidelines. Serum vitamin B12, serum folic acid, serum homocysteine and eGFR for each patient was measured and their association with the renal function and mortality outcome was noted.

Observation: A total of 100 patients (M:F=68:32) of chronic kidney disease were analyzed. Mean age of the study population was 51.55±16.23 years. On applying Pearson correlation between S. folic acid and eGFR, a linear correlation was found (p=0.001, correlation= 0.331). Similarly, an inverse correlation between S. homocysteine and eGFR (p<0.001, correlation=-0.573) was established. 15% patients died during the course of study. The mean folic acid among patients who died and patients who survived was 3.99±4.04ng/ml and 10.72±7.58ng/ml, respectively. The difference was statistically significant. The mean eGFR among those who died (mean=4.04±3.22ml/mint/1.73m2) was significantly lower (p<0.001) than the patients who survived during the study (mean=.16.22±12.66 ml/ mint/1.73m2).

Conclusion: Higher levels of homocysteine were more common in CKD patients as the disease progressed. It was also associated with poorer outcome (i.e. mortality risk). Advanced CKD staging was associated with increased mortality and lower folate levels. However, no association between serum vitamin B12 and renal/mortality outcome could be established in this study.