Author/Authors :
Badri, Shirinsadat Department of Clinical Pharmacy and Pharmacy Practice - Isfahan University of Medical Sciences, Isfahan, Iran , Vahdat, Sahar Isfahan Kidney Diseases Research Center - Isfahan University of Medical Sciences, Isfahan, Iran , Seirafian, Shiva Isfahan Kidney Diseases Research Center - Isfahan University of Medical Sciences, Isfahan, Iran , Pourfarzam, Morteza Department of Clinical Biochemistry - Isfahan University of Medical Sciences, Isfahan, Iran , Gholipur-Shahraki, Tahereh Department of Clinical Pharmacy and Pharmacy Practice - Isfahan University of Medical Sciences, Isfahan, Iran , Sara Ataei, Sara Department of Clinical Pharmacy - Hamadan University of Medical Sciences, Hamadan, Iran
Abstract :
The incidence of cardiovascular events and mortality is higher in patients with chronic kidney disease (CKD) compared to the general population. Homocysteine (Hcy) appears to be an independent risk factor for cardiovascular diseases in general populations and patients with CKD. Further, hyperhomocysteinemia can cause endothelial damage and increase the activity and production of coagulation factors, and its prevalence among patients with end-stage renal disease is approximately 85%–100%. Most treatments, which lower Hcy levels and have been considered in previous studies, include folic acid, B vitamins, omega-3 fatty acids, and N-acetylcysteine. However, the effect of therapies that can decrease Hcy levels and thus cardiovascular events in these patients is still unclear. The results are conflicting and require further investigation. To guide treatment decisions and improve patient outcomes, multiple databases were searched, including Web of Science, PubMed, and Medline to summarize the available evidence (i.e., clinical trial and meta-analyses) on Hcy-lowering interventions and cardiovascular events
