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Homocysteine loweri...
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Mann, Johannes F. E.
(author)
Homocysteine lowering with folic acid and B vitamins in people with chronic kidney disease : results of the renal Hope-2 study
- Article/chapterEnglish2008
Publisher, publication year, extent ...
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2007-10-30
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Oxford University Press (OUP),2008
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-104821
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-104821URI
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https://doi.org/10.1093/ndt/gfm485DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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BACKGROUND: Elevated plasma homocysteine levels are reported to be associated with higher rates of vascular diseases. Plasma homocysteine increases in chronic kidney disease (CKD) and could contribute to the increased cardiovascular risk in CKD. METHODS: Participants aged 55 years or older with CKD, defined as estimated GFR<60 ml/min and at high cardiovascular risk, were randomly assigned to the combination of folic acid, 2.5 mg, vitamin B6, 50 mg and vitamin B12, 1 mg (n = 307) or placebo (n = 312) daily for 5 years. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction and stroke. RESULTS: Mean baseline plasma homocysteine was 15.9 +/- 7.3 micromol/l in the active treatment group and 15.7 +/- 5.7 micromol/l in placebo group and decreased to 11.9 +/- 3.3 micromol/l (P < 0.001) on active treatment (15.5 +/- 4.5 on placebo). Primary outcome events occurred in 90 participants (29.3%) on active therapy and in 80 (25.6%) on placebo (relative risk, 1.19; 95% confidence interval, 0.88-1.61; P = 0.25). There were no significant treatment benefits on death from cardiovascular causes (1.24; 0.84-1.83), myocardial infarction (1.10; 0.76-1.61) and stroke (1.00; 0.54-1.85). More participants in the active treatment group were hospitalized for heart failure (1.98; 1.21-3.26; P = 0.007) and for unstable angina (1.70; 1.02-2.83; P = 0.04). Incidence of primary outcome increased with decreasing GFR. CONCLUSIONS: Active treatment with B vitamins lowered homocysteine levels in participants with CKD but did not reduce cardiovascular risk.
Subject headings and genre
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clinical trial
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homocysteine
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myocardial infarction
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stroke
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MEDICINE
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MEDICIN
Added entries (persons, corporate bodies, meetings, titles ...)
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Sheridan, Patrick
(author)
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McQueen, Matthew J.
(author)
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Held, Claes,1956-Munich Gen Hosp, Dept Med, Munich, Germany,UCR(Swepub:uu)clahe947
(author)
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Arnold, J. Malcolm O.
(author)
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Fodor, George
(author)
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Yusuf, Salim
(author)
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Lonn, Eva M.
(author)
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Munich Gen Hosp, Dept Med, Munich, GermanyUCR
(creator_code:org_t)
Related titles
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In:Nephrology, Dialysis and Transplantation: Oxford University Press (OUP)23:2, s. 645-6530931-05091460-2385
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