Folic acid supplementation in end-stage renal disease patients reduces total mortality rate

Shu Chen Chien, Szu Yuan Li, Yung Tai Chen, Lung Wen Tsai, Tzeng Ji Chen, Tzen Wen Chen, Yi Chun Lin

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Patients with end-stage renal disease (ESRD) are at high risk of cardiovascular disease and elevated serum homocysteine levels. Although folic acid supplementation has been documented to reduce serum homocysteine levels in ESRD patients, most trials of folic acid therapy for reducing cardiovascular diseases in ESRD patients have failed, mainly because of limited patient numbers. Methods: We used the Taiwan National Health Insurance Research Database (NHIRD) to conduct a matchedpair retrospective cohort study to clarify whether folic acid supplementation benefits ESRD patient survival. Patients were divided into a folic acid supplementation group and a control group. All-cause and cardiovascular-related mortality rates between groups were compared. Results: In total, 55,636 stable incident hemodialysis patients were identified from the database. Using a propensity score-matched method and intention-totreat analysis, the survival rate of 17,000 patients with folic acid supplementation was compared with a 1:1 matched control group. The baseline demographic data and comorbid disease incidence between the 2 groups were comparable. During the study period, the mortality rate in the matched pair cohort was 35.5% (n = 6,030) over a mean follow-up period of 3.0 years, corresponding to a mortality rate of 12.8/100 patient-years. The all-cause mortality rates were 12.3 and 13.4/100 patient-years in the folic acid group and control group, respectively (p = 0.005). Conclusions: In adult hemodialysis patients, folic acid supplementation improves cardiovascular and allcause mortality rates.

Original languageEnglish
Pages (from-to)1097-1104
Number of pages8
JournalJournal of Nephrology
Volume26
Issue number6
DOIs
Publication statusPublished - 2013

Fingerprint

Folic Acid
Chronic Kidney Failure
Mortality
Homocysteine
Control Groups
Renal Dialysis
Cardiovascular Diseases
Databases
Propensity Score
National Health Programs
Serum
Taiwan
Cohort Studies
Research Design
Survival Rate
Retrospective Studies
Demography
Survival
Incidence

Keywords

  • End-stage renal disease
  • Folic acid
  • Renal replacement therapy
  • Taiwan national health insurance research database

ASJC Scopus subject areas

  • Nephrology
  • Medicine(all)

Cite this

Chien, S. C., Li, S. Y., Chen, Y. T., Tsai, L. W., Chen, T. J., Chen, T. W., & Lin, Y. C. (2013). Folic acid supplementation in end-stage renal disease patients reduces total mortality rate. Journal of Nephrology, 26(6), 1097-1104. https://doi.org/10.5301/jn.5000276

Folic acid supplementation in end-stage renal disease patients reduces total mortality rate. / Chien, Shu Chen; Li, Szu Yuan; Chen, Yung Tai; Tsai, Lung Wen; Chen, Tzeng Ji; Chen, Tzen Wen; Lin, Yi Chun.

In: Journal of Nephrology, Vol. 26, No. 6, 2013, p. 1097-1104.

Research output: Contribution to journalArticle

Chien, Shu Chen ; Li, Szu Yuan ; Chen, Yung Tai ; Tsai, Lung Wen ; Chen, Tzeng Ji ; Chen, Tzen Wen ; Lin, Yi Chun. / Folic acid supplementation in end-stage renal disease patients reduces total mortality rate. In: Journal of Nephrology. 2013 ; Vol. 26, No. 6. pp. 1097-1104.
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