A Chinese study group found that the combination of antihypertensive medication and folic acid was more effective in preventing renal function decline and the progression of kidney disease than the antihypertensive treatment alone.
Chronic kidney disease (CKD) is a huge public health problem that may increase the risk of end-stage renal disease (ESRD) and cardiovascular disease (CVD). The most often used treatment is antihypertensive therapy, but when it progresses to ESRD, kidney transplantation may be the only option. Research has shown that the prevalence of hyperhomocysteinemia is higher in CKD patients and hyperhomocysteinemia might be a risk factor for CKD progression. However, folic acid and B vitamin, which are often used together in the treatment of hyperhomocysteinemia, have no proven effect on renal disease.
Patients with CKD had significantly higher blood pressure, serum homocysteine and fasting glucose and diabetes was more prevalent in this group. Also, the decrease in blood pressure was slightly higher in CKD patients. Additionally, the enalapril-folic acid group had a greater drop in homocysteine level, and the drop was even greater in the case of the patients with CKD at baseline. Furthermore, the enalapril-folic acid group had a significantly lower rate of renal function decline and a lower risk of rapid renal function decline, which were even more prominent in CKD patients.
The enalapril-folic acid therapy was able to slow down the progression of CKD in patients with hypertension. It seems that adding folic acid to the antihypertensive therapy might be a cheap, safe and beneficial treatment option for patients with CKD.
Written By: Dr. Fanni R. Eros