{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:04:30Z","timestamp":1787162670081,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,3]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>The efficacy of folic acid therapy to lower homocysteine (Hcy) levels in an effort to reduce cardiovascular disease (CVD) risk in patients with ESRD or advanced chronic kidney disease (ACKD; creatinine clearance, &lt;30 ml\/min) remains inconclusive. We conducted a meta-analysis of relevant randomized trials to further examine this issue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n                    <jats:p>This meta-analysis included 3886 patients with ESRD\/ACKD from seven qualified randomized trials using folic acid therapy and with CVD reported as one of the end points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      When pooling the seven trials, folic acid therapy reduced the risk of CVD by 15% (RR, 0.85; 95% CI, 0.76 to 0.96;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.009). A greater beneficial effect was observed among those trials with a treatment duration &gt;24 months (RR, 0.84; 95% CI, 0.72 to 0.98;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.02), a decrease in Hcy level &gt;20% (RR, 0.83; 95% CI, 0.73 to 0.95;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.007), and no or partial folic acid fortification (RR, 0.80; 95% CI, 0.65 to 0.99;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.04). The beneficial effect also was seen when Hcy levels decreased &gt;20%, even in the presence of folic acid fortification (RR, 0.85; 95% CI, 0.73 to 0.99;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.04). In the corresponding comparison groups, the estimated RRs were attenuated and insignificant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Folic acid therapy can reduce CVD risk in patients with ESRD\/ACKD by 15%. A greater beneficial effect was observed among those trials with no or partial folic acid fortification or a decrease in Hcy level &gt;20% regardless of folic acid fortification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.05310610","type":"journal-article","created":{"date-parts":[[2010,11,19]],"date-time":"2010-11-19T00:50:00Z","timestamp":1290127800000},"page":"482-488","source":"Crossref","is-referenced-by-count":64,"title":["Folic Acid Therapy and Cardiovascular Disease in ESRD or Advanced Chronic Kidney Disease"],"prefix":"10.2215","volume":"6","author":[{"given":"Xianhui","family":"Qin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Huo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig B.","family":"Langman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanfan","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yundai","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debora","family":"Matossian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiping","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-5-20230811","doi-asserted-by":"crossref","first-page":"2154","DOI":"10.1161\/01.CIR.0000095676.90936.80","article-title":"Kidney disease as a risk factor for development of cardiovascular disease: A 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