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CompletedNCT05807711Updated Jan 13, 2025

Efficacy of L-methylfolate and Methylcobalamine in Treating Resistant Hypertension Associated with Elevated Serum Homocysteine in Hemodialysis Patients.

A Phase 4 interventional study of L-Methyl Folate and methylcobalamine in End Stage Renal Disease and Hypertension, Renal, sponsored by Alexandria University. Completed at 1 site in Egypt. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2025-01-13.

Sponsored by Alexandria University · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
51
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

The aim of the study is to evaluate the efficacy of L-methylfolate in combination with methylcobalamine in reducing homocysteine blood levels in hypertensive end-stage renal disease patients on regular hemodialysis and its association with blood pressure control in treatment of resistant hypertension

Read the detailed description
  1. Ethical committee approval has been obtained from Ethics committee of Faculty of Medicine, Alexandria University
  2. Agreement from all participants should be taken in this clinical study by assigning an informed consent
  3. Adult end stage renal disease patients maintained on hemodialysis three times a week for at least 3 months with resistant hypertension will be recruited from hemodialysis unit in Alexandria University Hospitals
  4. Patients will be screened for resistant hypertension as determined by the mean of mid-week pre-dialysis BP > 140/90 mm Hg, post-dialysis BP > 130/80 mm Hg over a period of one month.
  5. A blood sample will be collected for homocysteine measurement at baseline
  6. Patients will be randomized using simple randomization technique via computer based program to take one tablet daily containing L-methylfolate and methylcobalamine or no treatment.
  7. Patients will be followed over a period of 3 months after which blood pressure measurement and blood sampling would be repeated and compared to baseline values
  8. As a measurement of the prognosis of elevated homocysteine, we should follow the development of myocardial infarction, stroke and cardiovascular events for 3 months
  9. The appropriate statistical tests will be held according to the study design and parameters to evaluate the significance of the results
  10. Results, conclusion, discussion and recommendations will be given
02

Conditions studied

  • End Stage Renal Disease
  • Hypertension, Renal

Keywords

  • L-methylfolate
  • methylcobalamine
  • homocysteine
03

In context

Kidney Failure, Chronic

2,085 studies on the registry are indexed under Kidney Failure, Chronic; 260 are open to participants now.

This study's enrollment of 51 is close to the median of 55 across 1,557 interventional studies indexed under Kidney Failure, Chronic.

Browse Kidney Failure, Chronic studies →

Lead sponsor

Alexandria University is the lead sponsor of 569 studies on the registry; 125 are open to participants now.

Of its 12 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Adult end stage renal disease patients maintained on hemodialysis three times a week for at least 3 months with resistant hypertension as determined by pre-dialysis BP > 140/90 mm Hg, post-dialysis BP > 130/80 mm Hg despite the use of three or more drugs

Exclusion criteria

Exclusion Criteria:

  • Age > 75 years
  • Excessive use of alcohol or smoking
  • Severe hepatic impairment
  • Acute kidney injury on top of chronic kidney disease
  • Pregnant females
  • Allergy or intolerance to any component of the formulation
  • Medication side effects (methotrexate, theophylline, phenytoin, and cyclosporine) or any drug proven to cause hyperhomocysteinemia
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
51 participants (actual)

Study arms

  • Active comparator
    Experimental: Intervention group

    Adult end stage renal disease patients maintained on hemodialysis three times a week for at least 3 months with resistant hypertension as determined by pre-dialysis BP \> 140/90 mm Hg, post-dialysis BP \> 130/80 mm Hg despite the use of three or more drugs. Patients will be assigned to take one tablet daily containing L-methylfolate and methylcobalamine. Patients will be followed over a period of 3 months after which blood pressure measurement and blood sampling would be repeated and compared to baseline values.

    Drug: L-Methyl Folate and methylcobalamine

  • No intervention
    No Intervention: Control group

    Adult end stage renal disease patients maintained on hemodialysis three times a week for at least 3 months with resistant hypertension as determined by pre-dialysis BP \> 140/90 mm Hg, post-dialysis BP \> 130/80 mm Hg despite the use of three or more drugs. Patients will be followed over a period of 3 months after which blood pressure measurement and blood sampling would be repeated and compared to baseline values.

Interventions

  • DrugL-Methyl Folate and methylcobalamine

    Dietary supplement labeled to contain methylfolate 800 micrograms and methylcobalamine 1000 micrograms

06

What researchers measure

Primary outcomes

  1. average pre-dialysis blood pressure target of ≤ 140/90 mm Hg or an average post-dialysis blood pressure target of ≤ 130/80 mm Hg

    To achieve an average pre-dialysis blood pressure target of ≤ 140/90 mm Hg or an average post-dialysis blood pressure target of ≤ 130/80 mm Hg. This should be parallel to lowering of serum homocysteine compared to baseline values

    Time frame: 3 months

Secondary outcomes

  1. myocardial infarction, stroke and cardiovascular events.

    As a measurement of the prognosis patients will be followed up for the development of myocardial infarction, stroke and cardiovascular events for 3 months.

    Time frame: 3 months

07

Study locations

1 site
  • Faculty of Pharmacy, Alexandria University
    Alexandria, 21521, Egypt
08

References and documents

Publications

  • Cianciolo G, La Manna G, Coli L, Donati G, D'Addio F, Persici E, Comai G, Wratten M, Dormi A, Mantovani V, Grossi G, Stefoni S. 5-methyltetrahydrofolate administration is associated with prolonged survival and reduced inflammation in ESRD patients. Am J Nephrol. 2008;28(6):941-8. doi: 10.1159/000142363. Epub 2008 Jun 30. PubMed 18587236 ↗
  • Friedman AN, Bostom AG, Selhub J, Levey AS, Rosenberg IH. The kidney and homocysteine metabolism. J Am Soc Nephrol. 2001 Oct;12(10):2181-2189. doi: 10.1681/ASN.V12102181. PubMed 11562419 ↗
  • Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004 Sep 23;351(13):1296-305. doi: 10.1056/NEJMoa041031. Erratum In: N Engl J Med. 2008;18(4):4. PubMed 15385656 ↗
  • Li J, Jiang S, Zhang Y, Tang G, Wang Y, Mao G, Li Z, Xu X, Wang B, Huo Y. H-type hypertension and risk of stroke in chinese adults: A prospective, nested case-control study. J Transl Int Med. 2015 Oct-Dec;3(4):171-178. doi: 10.1515/jtim-2015-0027. Epub 2015 Dec 30. PubMed 27847909 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 13, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05807711
Lead sponsor
Alexandria University
Responsible party
Sponsor
First posted
Apr 11, 2023
Start date
Apr 1, 2023
Primary completion
May 1, 2024
Completion
May 1, 2024
Last update
Jan 13, 2025

Study contacts

Hanan M El-gowelli, PhD
principal investigator · Professor of Pharmacology & Toxicology, Alexandria University
Hesham A Elghoneimy, PhD
principal investigator · Associate Professor of Internal Medicine, Alexandria University
Noha A Hamdy, PhD
principal investigator · Associate Professor of Clinical Pharmacy, Alexandria University
Mohamed S Salem, PharmD
principal investigator · Master's student in Clinical Pharmacy and Pharmacy Practice, Alexandria University.

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Mar 2023. You cannot join it, but the record below documents what was studied.

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