What is the effect of folic acid therapy on patients with chronic renal disease and hyperhomocysteinemia?
The results of studies on the effect of folic acid therapy on patients with chronic renal disease and hyperhomocysteinemia are inconsistent. In the Atherosclerosis and Folic Acid Supplementation Trial, a placebo-controlled study of 315 patients with chronic renal failure, folic acid supplementation did not reduce the composite risk of cardiovascular events, but did reduce the risk of stroke (RR reduction, 0.55; 95% CI, 0.01 0.80). Similarly, in the HOPE 2 study of patients with established vascular disease or diabetes mellitus, combination therapy with vitamin B6 , vitamin B12 , and folic acid lowered plasma homocysteine levels; did not affect the composite end point of cardiovascular death, MI, or stroke; but did reduce the risk of stroke.