Analisis crítico de dos revisiones sistemáticas: ¿Es útil el ácido fólico para prevenir eventos cardiovasculares en pacientes con enfermedad renal crónica terminal o avanzada?

José Peña, Juan Carlos Claro
2014 Revista médica de Chile (Impresa)  
Analisis crítico de dos revisiones sistemáticas: ¿Es útil el ácido fólico para prevenir eventos cardiovasculares en pacientes con enfermedad renal crónica terminal o avanzada? Patients with chronic kidney disease have an increased cardiovascular risk. Several non-traditional factors have been showed to be associated with this risk, including hyperhomocysteinemia. The effects of reducing homocysteine levels with folic acid supplementation have been studied in a number of randomized trials, with
more » ... ixed results. In this article we critically appraise two systematic reviews providing disparate conclusions about this question and we summarize their main findings using the GRADE methodology. We conclude that there are methodological differences that may explain the mixed results in both systematic reviews. Folic acid supplementation does not reduce cardiovascular morbidity or mortality in patients with chronic kidney disease at any stage. (Rev Med Chile 2014; 142: 636-645) Background and Objectives: The efficacy of folic acid therapy to lower homocysteine (Hcy) levels in an effort to reduce cardiovascular disease (CVD) risk in patients with ESRD or advanced chronic kidney disease (ACKD; creatinine clearance, < 30 ml/min) remains inconclusive. We conducted a meta-analysis of relevant randomized trials to further examine this issue. Design, Setting, Participants & Measurements: This meta-analysis included 3886 patients with ESRD/ACKD from seven qualified randomized trials using folic acid therapy
doi:10.4067/s0034-98872014000500013 pmid:25427022 fatcat:2nrup2zikbhthlaw4uvaqu22ny