[Should patients with chronic renal insufficiency be treated with folic acid, vitamin B6 and vitamin B12?].

Hyperhomocysteinemia is associated with CKD and increased cardiovascular risk. Treatment with folic acid and possibly vitamin B12 reduces homocysteine in renal insufficiency. At present there is no evidence of reduced mortality or morbidity following such treatment. This was confirmed in a recent study evaluating combined treatment with folic acid, B6 and B12 in chronic renal insufficiency and ESRD. While an ongoing study in renal transplant patients is anticipated, there is not sufficient evidence currently to recommend treatment of all chronic renal patients with folic acid, B6 or B12.