{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T20:58:06Z","timestamp":1782766686668,"version":"3.54.5"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2010,3,30]]},"abstract":"<jats:p>\n                    <jats:bold>\n                      <jats:italic>Background\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    In observational studies, hyperhomocysteinemia has been found to be a risk factor for total mortality and cardiovascular events in patients with end-stage renal disease. These patients have grossly elevated homocysteine levels that can be lowered by supplementation with folic acid and vitamin B\n                    <jats:sub>12<\/jats:sub>\n                    . We conducted a randomized clinical trial with B vitamins to reduce homocysteine levels and therefore cardiovascular events and total mortality.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Methods and Results\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    This randomized, double-blind multicenter study was conducted in 33 dialysis centers in north and east Germany between July 2002 and July 2008. We randomly assigned 650 patients with end-stage renal disease who were undergoing hemodialysis to 2 postdialysis treatments: 5 mg folic acid, 50 \u03bcg vitamin B\n                    <jats:sub>12<\/jats:sub>\n                    , and 20 mg vitamin B\n                    <jats:sub>6<\/jats:sub>\n                    (active treatment) or 0.2 mg folic acid, 4 \u03bcg vitamin B\n                    <jats:sub>12<\/jats:sub>\n                    , and 1.0 mg vitamin B\n                    <jats:sub>6<\/jats:sub>\n                    (placebo) given 3 times per week for an average of 2 years. The primary outcome was total mortality; the secondary outcome was fatal and nonfatal cardiovascular events. The primary outcome occurred in 102 patients (31%) receiving the active treatment and in 92 (28%) receiving placebo (hazard ratio, 1.13; 95% confidence interval, 0.85 to 1.50;\n                    <jats:italic>P<\/jats:italic>\n                    =0.51). The secondary outcome occurred in 83 patients (25%) receiving the active treatment and in 98 (30%) receiving placebo (hazard ratio, 0.80; 95% confidence interval, 0.60 to 1.07;\n                    <jats:italic>P<\/jats:italic>\n                    =0.13).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Conclusions\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Increased intake of folic acid, vitamin B\n                    <jats:sub>12<\/jats:sub>\n                    , and vitamin B\n                    <jats:sub>6<\/jats:sub>\n                    did not reduce total mortality and had no significant effect on the risk of cardiovascular events in patients with end-stage renal disease.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Clinical Trial Registration\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    URL: www.anzctr.org.au. Unique identifier: ACTRN12609000911291. URL: www.cochrane-renal.org. Unique identifier: CRG010600027.\n                  <\/jats:p>","DOI":"10.1161\/circulationaha.109.904672","type":"journal-article","created":{"date-parts":[[2010,3,16]],"date-time":"2010-03-16T00:09:20Z","timestamp":1268698160000},"page":"1432-1438","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":118,"title":["B Vitamins and the Risk of Total Mortality and Cardiovascular Disease in End-Stage Renal Disease"],"prefix":"10.1161","volume":"121","author":[{"given":"Judith","family":"Heinz","sequence":"first","affiliation":[{"name":"From the Institute of Clinical Chemistry (J.H., S.W., K.B., C.L., J.D.), Division of Nephrology (U.D., K.H.N.), and Institute of Biometry and Medical Informatics (S.K.), Magdeburg University Hospital, Magdeburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siegfried","family":"Kropf","sequence":"additional","affiliation":[{"name":"From the Institute of Clinical Chemistry (J.H., S.W., K.B., C.L., J.D.), Division of Nephrology (U.D., K.H.N.), and Institute of Biometry and Medical Informatics (S.K.), Magdeburg University Hospital, Magdeburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ute","family":"Domro\u0308se","sequence":"additional","affiliation":[{"name":"From the Institute of Clinical Chemistry (J.H., S.W., K.B., C.L., J.D.), Division of Nephrology (U.D., K.H.N.), and Institute of Biometry and Medical Informatics (S.K.), Magdeburg University Hospital, Magdeburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Westphal","sequence":"additional","affiliation":[{"name":"From the Institute of Clinical Chemistry (J.H., S.W., K.B., C.L., J.D.), Division of Nephrology (U.D., K.H.N.), and Institute of Biometry and Medical Informatics (S.K.), Magdeburg University Hospital, Magdeburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Borucki","sequence":"additional","affiliation":[{"name":"From the Institute of Clinical Chemistry (J.H., S.W., K.B., C.L., J.D.), Division of Nephrology (U.D., K.H.N.), and Institute of Biometry and Medical Informatics (S.K.), Magdeburg University Hospital, Magdeburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Luley","sequence":"additional","affiliation":[{"name":"From the Institute of Clinical Chemistry (J.H., S.W., K.B., C.L., J.D.), Division of Nephrology (U.D., K.H.N.), and Institute of Biometry and Medical Informatics (S.K.), Magdeburg University Hospital, Magdeburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus H.","family":"Neumann","sequence":"additional","affiliation":[{"name":"From the Institute of Clinical Chemistry (J.H., S.W., K.B., C.L., J.D.), Division of Nephrology (U.D., K.H.N.), and Institute of Biometry and Medical Informatics (S.K.), Magdeburg University Hospital, Magdeburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jutta","family":"Dierkes","sequence":"additional","affiliation":[{"name":"From the Institute of Clinical Chemistry (J.H., S.W., K.B., C.L., J.D.), Division of Nephrology (U.D., K.H.N.), and Institute of Biometry and Medical Informatics (S.K.), Magdeburg University Hospital, Magdeburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/74.1.130"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03530130055028"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.16.2015"},{"key":"e_1_3_2_4_2","first-page":"3642.","volume":"106","year":"2002","unstructured":"Baker F, Picton D, Blackwood S, Hunt J, Erskine M, Dyas M. 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