Written by Jessica Patella, ND. Meta-analysis of 9 randomized controlled trials that included a total of 8234 participants with kidney disease, showed that folic acid supplementation reduced the risk of cardiovascular disease by 10%.
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 maybe effective for preventing cardiovascular disease in populations with kidney disease, but more research should be conducted to confirm these results (1).
Source: Qin, Xianhui, Yong Huo, Di Xie, Fanfan Hou, Xiping Xu, and Xiaobin Wang. “Homocysteine-lowering therapy with folic acid is effective in cardiovascular disease prevention in patients with kidney disease: a meta-analysis of randomized controlled trials.” Clinical nutrition 32, no. 5 (2013): 722-727.
© 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Posted October 8, 2013.
Jessica Patella, ND, is a naturopathic physician specializing in nutrition and homeopathic medicine and offers a holistic approach to health. She earned her ND from Southwest College of Naturopathic Medicine in Tempe, AZ, and is a member of the North Carolina Association of Naturopathic Physicians. Visit her website at www.awarenesswellness.com.
References:
- Qin X, et al. Homocysteine-lowering therapy with folic acid is effective in cardiovascular disease prevention in patients with kidney disease: A meta-analysis of randomized controlled trials. 2013 Clinical Nutrition doi:10.1016/j.clnu.2012.12.009.
- Chronic Kidney Disease. CDC Features. Centers for Disease Control and Prevention.
- About Chronic Kidney Disease. National Kidney Foundation.
