Maintained Folic Acid Supplementation Reduces the Risk of Mortality in Continuous Ambulatory Peritoneal Dialysis Patients

Abstract

Background: The association between folic acid (FA) supplementation and mortality in continuous ambulatory peritoneal dialysis (CAPD) patients is unclear. Methods: FA exposure was calculated as a percentage of cumulative duration of drug usage to total follow-up duration (FA%). A total of 1,358 patients were classified by a cutoff value of FA%. The association of FA with mortality was evaluated using Cox proportional hazards models. Results: The cutoff value of FA% for predicting mortality was <34% at a median follow-up of 40.7 months. FA ≥34% was associated with decreased risk for all-cause (adjusted hazard ratios [HRs] 95% CI 0.64 [0.48-0.85] and cardiovascular mortality 0.67 (95% CI 0.47-0.97). Moreover, the adjusted HRs per 10% higher FA for all-cause and cardiovascular mortality were 0.925 (95% CI 0.879-0.973) and 0.926 (95% CI 0.869-0.988), respectively. Conclusions: Longer period of FA supplementation led to a reduction in risk of both all-cause and cardiovascular mortality in CAPD patients.

Effect of nutritional supplementation on mortality in peritoneal dialysis patients: A meta‐analysis

“…The full text of the remaining 27 studies was evaluated. According to the inclusion exclusion criteria, 19 studies were excluded for the following reasons: study not reporting survival outcome (12); study researching hemodialysis population (5); study about medicine intervention (2) (calcimimetics and sodium bicarbonate); and finally, 8 studies were included [13][14][15][16][17][18][19][20] (Figure 1).…”

The Relationship Between Serum Folate Level and Residual Renal Function in CAPD Patients

“… 9 Previous research reported that approximately 40–60% of deaths among PD patients are related to CVD, 10 while long-term FA supplementation significantly reduces all-cause mortality and cardiovascular mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. 11 FA cannot be synthesized by the human body, so its physiological level is entirely dependent on exogenous FA intake. 12 The upper small intestine is the main FA absorption site; patients who have renal function damage up to uraemia often have concomitant gastrointestinal symptoms such as nausea, vomiting and loss of appetite, which decreases FA intake to a certain extent.…”