Lowering Homocysteine Offers No Mortality Benefit in Severe Kidney Disease

Although high levels of homocysteine are associated with complications of vascular disease, lowering homocysteine with high doses of B vitamins does not reduce the risk for death in patients with chronic or end-stage kidney disease, according to a study in JAMA.
More than 2000 patients with advanced kidney disease in 36 Veterans Affairs medical centers were randomized to receive placebo or 40 mg of folic acid, 100 mg of B6, and 2 mg of B12.
Patients in the treatment group lowered their mean homocysteine levels by 26% at 3 months, but treatment showed no benefit over placebo on all-cause mortality over a median follow-up of about 3 years (hazard ratio, 1.04).
"The findings echo the results of several large-scale trials in other high-risk populations," Thomas L. Schwenk writes in Journal Watch General Medicine. Currently, "there is no clinical basis for supplementation."