Featured Research

from universities, journals, and other organizations

Lowering Homocysteine Levels Does Not Improve Outcomes For Patients With Chronic Kidney Disease

Date:
September 19, 2007
Source:
JAMA and Archives Journals
Summary:
Patients with end-stage kidney disease treated with high doses of folic acid and B vitamins to lower homocysteine levels did not have improvement in survival or reductions in the incidence of vascular events, according to a new study.

Patients with end-stage kidney disease treated with high doses of folic acid and B vitamins to lower homocysteine levels did not have improvement in survival or reductions in the incidence of vascular events, according to a study in the September 12 issue of JAMA.

Numerous studies have shown that high plasma levels of homocysteine are associated with vascular disease. Patients with chronic kidney disease or end-stage renal disease (ESRD) have extensive vascular disease, with estimates of an annual rate of death as high as 20 percent, according to background information in the article. Folic acid and B vitamins decrease homocysteine levels in these patients, but whether they lower the rate of death and vascular events is not known.

Rex L. Jamison, M.D., of the Veterans Affairs (VA) Palo Alto Health Care Systems and Stanford University School of Medicine, Stanford, Calif., and colleagues conducted a study to determine whether treatment with a combination of high-dose folic acid and B vitamins can reduce the rate of death and cardiovascular events in patients with advanced chronic kidney disease (ACKD) and ESRD. The randomized controlled trial (2001-2006), involving 36 VA medical centers, included patients with ACKD (n = 1,305) or ESRD (n = 751) and high homocysteine levels. Median (midpoint) follow-up was 3.2 years. Participants received a daily capsule containing folic acid and vitamin B6 and B12 or a placebo.

After three months, patients in the vitamin group had their homocysteine level lowered by about 26 percent, while this level decreased by 1.7 percent in the placebo group. This 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.

"What might account for the failure of the treatment in our study" Possibly the underlying burden of disease was too great for a measurable benefit from lowering homocysteine," the authors write.

"Our findings do not support the administration of folic acid and B vitamin supplements to prevent vascular injury or improve survival in patients with ACKD or ESRD."

Reference: JAMA. 2007;298(10):1163-1170.

Editorial: B Vitamins for the Prevention of Vascular Disease -- Insufficient Evidence to Justify Treatment

In an accompanying editorial, Colin Baigent, B.M., B.Ch., F.R.C.P., and Robert Clarke, M.D., F.R.C.P., of the University of Oxford, England, speculate on why this and other trials have failed to show B vitamins as an effective treatment for this condition.

"Possible reasons for the failure of the 5 completed trials to demonstrate statistically definite effects on vascular risk include an inadequate number of recorded events or insufficient duration of treatment; an attenuation of the benefit owing to folic acid fortification in North America, where most of the trials have been conducted to date; or a true failure of treatment to reduce vascular risk."

Reference for editorial: JAMA. 2007;298(10):1212-1214.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Cite This Page:

JAMA and Archives Journals. "Lowering Homocysteine Levels Does Not Improve Outcomes For Patients With Chronic Kidney Disease." ScienceDaily. ScienceDaily, 19 September 2007. <www.sciencedaily.com/releases/2007/09/070911163342.htm>.
JAMA and Archives Journals. (2007, September 19). Lowering Homocysteine Levels Does Not Improve Outcomes For Patients With Chronic Kidney Disease. ScienceDaily. Retrieved July 22, 2014 from www.sciencedaily.com/releases/2007/09/070911163342.htm
JAMA and Archives Journals. "Lowering Homocysteine Levels Does Not Improve Outcomes For Patients With Chronic Kidney Disease." ScienceDaily. www.sciencedaily.com/releases/2007/09/070911163342.htm (accessed July 22, 2014).

Share This




More Health & Medicine News

Tuesday, July 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

TheStreet (July 21, 2014) New research shows Gilead Science's drug Sovaldi helps in curing hepatitis C in those who suffer from HIV. In a medical study, the combination of Gilead's Hep C drug with anti-viral drug Ribavirin cured 76% of HIV-positive patients suffering from the most common hepatitis C strain. Hepatitis C and related complications have been a top cause of death in HIV-positive patients. Typical medication used to treat the disease, including interferon proteins, tended to react badly with HIV drugs. However, Sovaldi's %1,000-a-pill price tag could limit the number of patients able to access the treatment. TheStreet's Keris Lahiff reports from New York. Video provided by TheStreet
Powered by NewsLook.com
$23.6 Billion Awarded To Widow In Smoking Lawsuit

$23.6 Billion Awarded To Widow In Smoking Lawsuit

Newsy (July 20, 2014) Cynthia Robinson claims R.J. Reynolds Tobacco Company hid the health and addiction risks of its products, leading to the death of her husband in 1996. Video provided by Newsy
Powered by NewsLook.com
Tooth Plaque Provides Insight Into Diets Of Ancient People

Tooth Plaque Provides Insight Into Diets Of Ancient People

Newsy (July 19, 2014) Research on plaque from ancient teeth shows that our prehistoric ancestor's had a detailed understanding of plants long before developing agriculture. Video provided by Newsy
Powered by NewsLook.com
Contaminated Water Kills 3 Babies in South African Town

Contaminated Water Kills 3 Babies in South African Town

AFP (July 18, 2014) Contaminated water in South Africa's northwestern town of Bloemhof kills three babies and hospitalises over 500 people. The incident highlights growing fears over water safety in South Africa. Duration: 02:22 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins