ROLE OF FOLIC ACID IN CARDIOVASCULAR HEALTH IN KIDNEY PATIENTS An estimated 26 million Americans have chronic kidney disease (2,3). Chronic kidney disease increases the risk of developing heart disease and hypertension. The reverse is also true: hypertension and heart disease increases the risk of developing kidney disease (3). Due to the fact that kidney disease and cardiovascular disease are interrelated, research is beginning to investigate the two together, instead of as separate diseases. Recent research has found that supplementing with folic acid is beneficial for reducing cardiovascular disease in patients with kidney disease (1). The recent research was a meta-analysis of 9 randomized controlled trials, including a total of 8234 participants with kidney disease (end-stage renal disease, advanced chronic kidney disease or chronic kidney disease) (1). When combining all 9 study results, folic acid supplementation reduced the risk of cardiovascular disease by 10% (RR=0.90, 95%CI 0.81-1.00, P=0.046). This was determined by the number of cardiovascular events, such as a heart attack or stroke, that occurred during the study period, compared to placebo groups. The dosage of folic acid ranged from 2 mg per day to 40 mg per day, with 5 mg per day or 15 mg per day being the most common dosage amounts across the 9 studies (1). A greater beneficial effect was observed in the trials of participants who did not eat grains fortified with folic acid (RR=0.82, 95% CI 0.70-0.96, P=0.01), participants with higher baseline homocysteine levels (greater than or equal to 25 micromol/L, RR=0.87, 95% CI 0.76-1.00, P=0.049), trials with higher percentages of current smokers (15% or greater, RR=0.83, 95% CI 0.73-0.95, P=0.005), trials with a lower baseline percentage of participants with diabetes (less than 30%, RR=0.80, 95% CI 0.65-0.99, P=0.04) and in participants specifically with end-stage renal disease or advanced chronic kidney disease (RR=0.85, 95% CI 0.77-0.94, P=0.002) (1). In conclusion, folic acid supplementation was effective for preventing major cardiovascular events, such as heart attack and stroke, in patients with kidney disease, specifically end-stage renal disease and advanced chronic kidney disease. Researchers suggest folic acid supplementation may be effective for preventing cardiovascular disease in populations with kidney disease, but more research should be conducted to confirm these results (1).
Posted on: Wed, 30 Oct 2013 17:51:42 +0000
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