ATLANTA— Oral folic acid therapy may be a cost-effective addition to anemia management in patients on peritoneal dialysis (PD), study findings presented at the American Society of Nephrology’s Kidney Week 2013 meeting suggest.
Subir K. Paul, MD, and colleagues at Shoals Kidney and Hypertension Center in Florence, Ala., studied the effect of folic acid treatment on plasma hemoglobin concentration in 16 PD patients (mean age 47.8 years) with plasma Hb levels below 11 g/dL, a folic acid level of 5 ng/mL or less, and iron saturation more than 20%. Patients were treated with 3-5 mg of oral folic acid daily. All patients had normal vitamin 12 levels. The researchers evaluated serum folic acid levels and plasma Hb at four weeks prior to initiation of therapy, at initiation, and four weeks after initiation. Maintenance therapy with intravenous iron and epoetin alfa were continued according to standard protocol.
At four weeks prior to initiation and at initiation, patients’ mean folic acid level was 3.93 and 3.96 ng/mL, respectively. Following therapy with folic acid, mean folic acid level rose from 3.96 to 19.26 ng/dL. During the pretreatment phase, mean plasma Hb level remained unchanged at 10.42 and 10.29 g/dL (four weeks prior to therapy and at initiation of therapy). Following folic acid therapy, mean plasma Hb level improved significantly from 10.29 to 11.30 g/dL and mean epoetin alfa dose decreased significantly from 14,875 units to 10,437 units every two weeks.