Chronic Kidney Disease

CKD: Vitamin B12 Individually (2018)

• Intervention
  What is the effect of vitamin B12 supplementation on homocysteine levels in adults with CKD 1-5D and post-transplant?

  • Conclusion

    The effect of vitamin B12 on homocysteine levels were mixed in primarily vitamin B-12 replete participants. Two studies concluded no effect, while two studies demonstrated decrease in homocysteine levels according to the vitamin B12 supplementation dose in CKD maintenance hemodialysis (MHD) participants.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of vitamin B12 supplementation on homocysteine levels in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Arnadottir M, Hultberg B. The effect of vitamin B12 on total plasma homocysteine concentration in folate-replete hemodialysis patients. Clinical Nephrology 2003; 59:186-9
      • Chiu Y, Chang J, Hwang S, Tsai J, Chen H. Pharmacological dose of vitamin B12 is as effective as low-dose folinic acid in correcting hyperhomocysteinemia of hemodialysis patients. Renal Failure 2009; 31:278-83
      • Hoffer L, Saboohi F, Golden M, Barré P. Cobalamin dose regimen for maximum homocysteine reduction in end-stage renal disease. Metabolism: Clinical and Experimental 2005; 54:835-40
      • Trimarchi H, Schiel A, Freixas E, Díaz M. Randomized trial of methylcobalamin and folate effects on homocysteine in hemodialysis patients. Nephron 2002; 91:58-63
  • Search Plan and Results: CKD: Micronutrients: Vitamin B12 (2018)
     
  What is the effect of vitamin B12 supplementation on vitamin B12 levels in adults with CKD 1-5D and post-transplant?

  • Conclusion

    Vitamin B12 supplementation increased vitamin B12 biomarkers, and there was evidence of a dose-response effect according to supplementation dosage. Most participants were vitamin B12 replete, but vitamin B12 status was not reported in all studies. Lack of comparison of results to a reference standard limits interpretation of findings.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of vitamin B12 supplementation on vitamin B12 levels in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Arnadottir M, Hultberg B. The effect of vitamin B12 on total plasma homocysteine concentration in folate-replete hemodialysis patients. Clinical Nephrology 2003; 59:186-9
      • Chiu Y, Chang J, Hwang S, Tsai J, Chen H. Pharmacological dose of vitamin B12 is as effective as low-dose folinic acid in correcting hyperhomocysteinemia of hemodialysis patients. Renal Failure 2009; 31:278-83
      • Hoffer L, Saboohi F, Golden M, Barré P. Cobalamin dose regimen for maximum homocysteine reduction in end-stage renal disease. Metabolism: Clinical and Experimental 2005; 54:835-40
      • Trimarchi H, Schiel A, Freixas E, Díaz M. Randomized trial of methylcobalamin and folate effects on homocysteine in hemodialysis patients. Nephron 2002; 91:58-63
  • Search Plan and Results: CKD: Micronutrients: Vitamin B12 (2018)