Efficacy of IV methylcobalamin and oral folic acid in the treatment of uremic neuropathy in chronic haemodialysis patients

The aim of the present study was to assess the efficacy of methylcobalamin and folic acid for the treatment of uremic neuropathy. The study was conducted on 35 chronic renal failure patients on maintenance haemodialysis. All the patients were given 500µg of intravenous methylcobalamin thrice weekly after each dialysis session and 5mg of folic acid orally daily for 6 months. The following points were noted at the start and at the end of the study–(i) Serum vitamin B12 levels (ii) Serum folic acid levels (iii) Neuropathic pain/paresthesia grading (Modified published criteria by Dyck et al) (iv) Neurological disability score (v) Neurological symptom score (vi) Nerve conduction studies. High dose supplementation of methylcobalamin and folic acid led to ultrahigh serum levels along with significant clinical and electrophysiological improvement in neuropathy.