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学科主题: 临床医学
题名:
Folic Acid Therapy and Cardiovascular Disease in ESRD or Advanced Chronic Kidney Disease: A Meta-Analysis
作者: Qin, Xianhui4; Huo, Yong5,6; Langman, Craig B.7; Hou, Fanfan8; Chen, Yundai9; Matossian, Debora7; Xu, Xiping10; Wang, Xiaobin1,2,3
刊名: CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
发表日期: 2011-03-01
DOI: 10.2215/CJN.05310610
卷: 6, 期:3, 页:482-488
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Urology & Nephrology
研究领域[WOS]: Urology & Nephrology
关键词[WOS]: RANDOMIZED CONTROLLED-TRIAL ; STAGE RENAL-DISEASE ; RISK-FACTOR ; B-VITAMINS ; HOMOCYSTEINE ; MORTALITY ; EVENTS ; SUPPLEMENTATION ; PREVENTION ; STATEMENT
英文摘要:

Background and objectives 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, <30 ml/min) remains inconclusive. We conducted a meta-analysis of relevant randomized trials to further examine this issue.

Design, setting, participants, & measurements 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.

Results 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; P = 0.009). A greater beneficial effect was observed among those trials with a treatment duration >24 months (RR, 0.84; 95% Cl, 0.72 to 0.98; P = 0.02), a decrease in Hcy level >20% (RR, 0.83; 95% CI, 0.73 to 0.95; P = 0.007), and no or partial folic acid fortification (RR, 0.80; 95% CI, 0.65 to 0.99; P = 0.04). The beneficial effect also was seen when Hcy levels decreased >20%, even in the presence of folic acid fortification (RR, 0.85; 95% CI, 0.73 to 0.99; P = 0.04). In the corresponding comparison groups, the estimated RRs were attenuated and insignificant.

Conclusions 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 >20% regardless of folic acid fortification. Clin J Am Soc Nephrol 6: 482-488, 2011. doi: 10.2215/CJN.05310610

语种: 英语
WOS记录号: WOS:000288480100005
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/54676
Appears in Collections:北京大学第一临床医学院_心血管内科_期刊论文

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作者单位: 1.Peking Univ, Hosp 1, Ctr Heart, Beijing 100871, Peoples R China
2.Childrens Mem Res Ctr, Chicago, IL USA
3.Anhui Med Univ, Inst Biomed, Hefei, Peoples R China
4.NW Univ Feinberg, Sch Med, Childrens Mem Hosp, Mary Ann & J Milburn Smith Child Hlth Res Program, Chicago, IL 60614 USA
5.NW Univ Feinberg, Sch Med, Dept Pediat, Mary Ann & J Milburn Smith Child Hlth Res Program, Chicago, IL 60614 USA
6.Peking Univ, Hosp 1, Dept Cardiol, Beijing 100871, Peoples R China
7.NW Univ Feinberg, Sch Med, Childrens Mem Hosp, Div Kidney Dis, Chicago, IL 60614 USA
8.So Med Univ, Nanfang Hosp, Div Nephrol, Guangzhou, Guangdong, Peoples R China
9.Peoples Liberat Army Gen Hosp, Dept Cardiol, Beijing, Peoples R China
10.Univ Illinois, Chicago Sch Publ Hlth, Div Epidemiol & Biostat, Chicago, IL USA

Recommended Citation:
Qin, Xianhui,Huo, Yong,Langman, Craig B.,et al. Folic Acid Therapy and Cardiovascular Disease in ESRD or Advanced Chronic Kidney Disease: A Meta-Analysis[J]. CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY,2011,6(3):482-488.
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