Variations in the lipid profile of patients with chronic renal failure treated with pyridoxine

De, Giammona, Touceda

Description

Hyperhomocysteinemia and lipid abnormalities are commonly found in patients with chronic renal failure; both are recognized as risk factors for atherosclerosis. The homocysteine-lowering effect of pyridoxine is controversial. This study was performed to determine the effect of a high dose of pyridoxine (300 mg i.v. three times a week) on plasma and red blood cell lipid profile and plasma homocysteine concentration in twelve chronic renal failure patients on regular hemodialysis. Fasting blood samples were taken at the beginning of the study (basal 1), after 30 and 60 days of treatment and 4 months after withdrawal (basal 2). Results Pyridoxine supplementation induced a significant decrease in total plasma homocysteine level and also a lowering effect in plasma total cholesterol and triglycerides. These biochemical data increased when the samples were taken at basal 2, reaching the levels obtained at the beginning of the experiment. LDL cholesterol increased whereas HDL cholesterol was reduced during the treatment. In erythrocyte membranes vitamin B6 therapy enhanced the cholesterol/phospholipid ratio as well as the fluorescence anisotropy of diphenyl-hexatriene. Conclusions We conclude that high doses of pyridoxine represent an effective strategy to ameliorate both plasma homocysteine levels and lipid profiles in chronic renal failure patients, protecting them from atherosclerosis. Further research using a long-term treatment would be necessary in an attempt to restore the fatty acid pattern and the fluidity of red cell membranes.

Sujets

• Cholestérol
• Chronic kidney disease
• Homocystéine
• Polyunsaturated fat
• Pyridoxine
• Triglycéride

Informations

• Publié par: biomed
• Publié le: 01 janvier 2003
• Nombre de lectures: 22
• Langue: English

Extrait

Lipids in Health and Disease

BioMedCentral

Open Access Research Variations in the lipid profile of patients with chronic renal failure treated with pyridoxine 1 2 Nelva T de Gómez Dumm*, Ana M Giammona and Luis A Touceda

1 2 Address: Institutode Investigaciones Bioquímicas de La Plata (INIBIOLPCONICETUNLP) andCátedra de Medicina Interna, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, 60 y 120, 1900, La Plata, Argentina. Fax: 54:221 4258988 Email: Nelva T de Gómez Dumm*  [e-mail]; Ana M Giammona  [e-mail]; Luis A Touceda  [e-mail] * Corresponding author

Published: 18 September 2003Received: 28 August 2003 Accepted: 18 September 2003 Lipids in Health and Disease2003,2:7 This article is available from: http://www.Lipidworld.com/content/2/1/7 © 2003 de Gómez Dumm et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permit- ted in all media for any purpose, provided this notice is preserved along with the article's original URL.

cholesterolchronic renal failurehomocysteinepolyunsaturated fatty acidspyridoxinetriglyceride Abstract Background:Hyperhomocysteinemia and lipid abnormalities are commonly found in patients with chronic renal failure; both are recognized as risk factors for atherosclerosis. The homocysteine-lowering effect of pyridoxine is controversial. This study was performed to determine the effect of a high dose of pyridoxine (300 mg i.v. three times a week) on plasma and red blood cell lipid profile and plasma homocysteine concentration in twelve chronic renal failure patients on regular hemodialysis. Fasting blood samples were taken at the beginning of the study (basal 1), after 30 and 60 days of treatment and 4 months after withdrawal (basal 2). Results:Pyridoxine supplementation induced a significant decrease in total plasma homocysteine level and also a lowering effect in plasma total cholesterol and triglycerides. These biochemical data increased when the samples were taken at basal 2, reaching the levels obtained at the beginning of the experiment. LDL cholesterol increased whereas HDL cholesterol was reduced during the treatment. In erythrocyte membranes vitamin B6 therapy enhanced the cholesterol/phospholipid ratio as well as the fluorescence anisotropy of diphenyl-hexatriene. Conclusions:We conclude that high doses of pyridoxine represent an effective strategy to ameliorate both plasma homocysteine levels and lipid profiles in chronic renal failure patients, protecting them from atherosclerosis. Further research using a long-term treatment would be necessary in an attempt to restore the fatty acid pattern and the fluidity of red cell membranes.

Background Ischemic heart disease and other complications of athero sclerosis are the most common cause of death in patients with chronic renal failure. The pathogenesis of cardiovas cular diseases in these patients is of multifactorial origin [1]. Dislipidemia and hyperhomocysteinemia are impor tant factors associated with the early onset of atherosclerosis.

Chronic renal failure is often associated with dyslipopro teinemia, high levels of cholesterol and triglycerides, as well as a decrease in the polyunsaturated fatty acids. Each of these abnormalities has been identified as an independent risk factor for atherosclerosis [2–5]. Some of them persisting and becoming worse during dialysis treat ment [6]. On the other hand, an increment of plasma homocysteine concentration is highly prevalent among

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