A NEW METHOD OF CORRECTION OF HYPERHOMOCYSTEINEMIA IN CHRONIC HEMODIALYSIS PATIENTS

THE AIM of the investigation was to evaluate the influence of thiol-containing substance DMPS on the reduction of plasma total homocysteine (Hcy) concentration in hemodialysis (HD) patients. PATIENTS AND METHODS. A four-week long open controlled prospective investigation was carried on to compare the effectiveness of monotherapy with group B vitamins and combined therapy with sodium 2,3-dimercapto-1-propanesulfonate (DMPS) in combination with group B vitamins in relation to a decrease of the concentration of total Hcy in blood plasma of chronic HD patients. In the main group patients (n=20) a HD session with a subcutaneous (n=10) or intravenous (n=10) injection of DMPS was followed by an intravenous injection of calcium folinate and vitamins B 12and B 6 . In the control group consisting of 20 patients only a course of group B vitamins was performed. RESULTS. A session of standard HD resulted in a 32± 8% less level of plasma Hcy. A more pronounced decrease of Hcy after HD was observed following a subcutaneous (by 56±17%) and intravenous (by 57±10%) injection of DMPS. The calculated Hcy excretion was 62.3±29.2 мmol for a standard HD session and 224.0±57.0 мmol for the HD session preceded by a subcutaneous injection of DMPS. The 4 week-long course of group B vitamins resulted in a decreased level of Hcy at an average by 43±19% (30.5±12.3 мmol/l before the course of treatment and 16.0±4.3 мmol /l after the course at an average).The same scheme of treatment after a single subcutaneous injection of DMPS resulted in a substantially more considerable reduction (normalization) of plasma Hcy: at an average by 65± 9%, from 27.4±5.3 мmol /l to 9.7±1.8 мmol/l . CONCLUSION. DMPS considerably increases excretion of Hcy during the HD session, results in a rapid and substantially decreased level of plasma Hcy and allows improvement of the effect of correction of hyperhomocysteinemia using group B vitamins.

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