A U.S. study
suggests lowering homocysteine levels in end-stage kidney disease patients
does not improve survival or reduce vascular events.
Patients with
end-stage kidney disease are often treated with high doses of folic acid
and B vitamins to lower their levels of the amino acid homocysteine, which
has been associated with vascular disease.
Dr. Rex Jamison
of the Stanford University School of Medicine and colleagues conducted
a randomized controlled trial at 36 Veterans Administration medical
centers involving end-stage kidney patients being given either a daily
capsule containing folic acid and vitamin B6 and B12 or a placebo.
After three
months, homocysteine levels in vitamin group patients had been lowered
by about 26 percent, while the level decreased by 1.7 percent in the placebo
group.
But the researchers
said the treatment had no significant effect on the rate of death between
the two groups -- 448 deaths in the vitamin group vs. 436 deaths in the
placebo group. Treatment also had no significant effect on other outcomes
such as heart attack, stroke and amputation.
The study is
reported in the Journal of the American Medical Association.
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