Abstract

Objectives: We investigated the effects of folic acid supplementation on plasma total homocysteine levels and carotid intima-media thickness after kidney transplant. Materials and Methods: 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. Results: 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 mu mol/L at baseline, 18.7 mu mol/L after 2 months, 19.3 mu mol/L after 4 months, and 20 mu mol/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 mu mol/L at baseline, 4.7 mu mol/L after 2 months, 12.9 mu mol/L after 4 months, and 10.9 mu mol/L after 6 months; and the carotid intima-media thickness measurements 0.72 mm after 4 months, and 0.71 mm after 6 months. Conclusions: Folic acid supplementation reduces both the plasma total homocysteine level and carotid intima-media thickness shortly after kidney transplant.