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Background : Vitamin B 12  deficiency and renal impairment are common in the aged, and therefore the screening test for vitamin B 12  deficiency should not be affected by renal function. Renal impairment has been associated with increased concentrations of plasma total homocysteine and methylmalonic acid, as well as increased total vitamin B 12  and holotranscobalamin concentrations.

clinical chemistry and laboratory medicine

Renal impairment compromises the use of total homocysteine and methylmalonic acid but not total vitamin B 12  and holotranscobalamin in screening for vitamin B 12  deficiency in the aged