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 October 20, 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 October 20, 2014).

Share This



More Health & Medicine News

Monday, October 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Microneedle Patch Promises Painless Pricks

Microneedle Patch Promises Painless Pricks

Reuters - Innovations Video Online (Oct. 18, 2014) Researchers at The National University of Singapore have invented a new microneedle patch that could offer a faster and less painful delivery of drugs such as insulin and painkillers. Video provided by Reuters
Powered by NewsLook.com
Raw: Nurse Nina Pham Arrives in Maryland

Raw: Nurse Nina Pham Arrives in Maryland

AP (Oct. 17, 2014) The first nurse to be diagnosed with Ebola at a Dallas hospital walked down the stairs of an executive jet into an ambulance at an airport in Frederick, Maryland, on Thursday. Pham will be treated at the National Institutes of Health. (Oct. 16) Video provided by AP
Powered by NewsLook.com
Raw: Cruise Ship Returns to US Over Ebola Fears

Raw: Cruise Ship Returns to US Over Ebola Fears

AP (Oct. 17, 2014) A Caribbean cruise ship carrying a Dallas health care worker who is being monitored for signs of the Ebola virus is heading back to Texas, US, after being refused permission to dock in Cozumel, Mexico. (Oct. 17) Video provided by AP
Powered by NewsLook.com
Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

AFP (Oct. 17, 2014) All four suspected Ebola cases admitted to hospitals in Spain on Thursday have tested negative for the deadly virus in a first round of tests, the government said Friday. Duration: 00:55 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:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

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