Trial reportAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2009
Homocysteine lowering and cognition in CKD: the Veterans Affairs homocysteine study.
Trial report in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 9 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 9 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- Pooled it
- The preventive efficacy of vitamin B supplements on the cognitive decline of elderly adults: a systematic review and meta-analysis.BMC geriatrics · 2021Pooled it
- Association of Methylenetetrahydrofolate Reductase C677T Gene Polymorphisms with Mild Cognitive Impairment Susceptibility: A Systematic Review and Meta-Analysis.Behavioural neurology · 2021Pooled it
- Vitamin B-Can it prevent cognitive decline? A systematic review and meta-analysis.Systematic reviews · 2020Pooled it
- Pharmacological interventions for heart failure in people with chronic kidney disease.The Cochrane database of systematic reviews · 2020Pooled it
- Effect of Vitamin B Supplementation on Cognitive Function in the Elderly: A Systematic Review and Meta-Analysis.Drugs & aging · 2019Pooled it
- Interventions for lowering plasma homocysteine levels in dialysis patients.The Cochrane database of systematic reviews · 2016Pooled it
- Mild cognitive impairment and dementia: the importance of modifiable risk factors.Deutsches Arzteblatt international · 2011Pooled it
- Treatment of cardiovascular risk factors to prevent cognitive decline and dementia: a systematic review.Vascular health and risk management · 2010Pooled it
- Response of serum and red blood cell folate concentrations to folic acid supplementation depends on methylenetetrahydrofolate reductase C677T genotype: results from a crossover trial.Molecular nutrition & food research · 2013Trial
- Microbiota-derived metabolites and cognitive dysfunction in dialysis patients: mechanisms and targeted therapeutic strategies.Frontiers in microbiology · 2026Review
- Cognitive impairment in chronic kidney disease: mechanisms, clinical manifestations, and management strategies.Metabolic brain disease · 2025Review
- Uremic Toxins, CKD, and Cognitive Dysfunction.Journal of the American Society of Nephrology : JASN · 2025Review
- Interventions to improve cognitive performance in chronic kidney disease: A scoping review.PloS one · 2025Article
- The relationship between thiamin, folic acid and cognitive function in a rat model of uremia.Renal failure · 2024Article
- Unraveling of Molecular Mechanisms of Cognitive Frailty in Chronic Kidney Disease: How Exercise Makes a Difference.Journal of clinical medicine · 2024Review
- Cognitive disorders in patients with chronic kidney disease: specificities of clinical assessment.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021Review
- Mechanisms of cognitive dysfunction in CKD.Nature reviews. Nephrology · 2020Review
- Cerebrovascular Disease and Cognition in Chronic Kidney Disease Patients.Frontiers in cardiovascular medicine · 2020Review
- Chronic kidney disease in the pathogenesis of acute ischemic stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundIndividuals with advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) have high plasma total homocysteine (tHcy) levels, which may be a risk factor for cognitive impairment. Whether treatment with high-dose B vitamins to decrease high tHcy levels improves cognition in persons with kidney disease is unknown. STUDY
designRandomized controlled trial. SETTING &
participantsA substudy of 659 patients (mean age, 67.3 +/- 11.7 years) who participated in a randomized double-blind clinical trial 5 years in duration conducted in 36 US Department of Veterans Affairs medical centers of the effect on all-cause mortality of vitamin-induced lowering of plasma tHcy level. 236 (35.8%) were treated by using dialysis (ESRD) and 423 (64.2%) had a Cockcroft-Gault estimated creatinine clearance of 30 mL/min or less (advanced CKD). All had high tHcy levels (> or =15 micromol/L) at baseline. Cognitive assessments began during the follow-up period of the main trial 3 years after treatment began; participants subsequently were retested 1 year later to assess cognitive change.
interventionDaily high-dose B vitamin capsule (40 mg of folic acid, 100 mg of vitamin B(6), and 2 mg of vitamin B(12)) or placebo. OUTCOMES: Cognitive function at initial assessment and 1 year later. MEASUREMENTS: Telephone Interview of Cognitive Status-modified, supplemented with attention, working memory, and executive function tests.
resultsInitial cognitive function was impaired in approximately 19% of patients regardless of treatment assignment (vitamin or placebo) or kidney disease status (advanced CKD or ESRD). Treatment decreased tHcy levels by 26.7%. Unadjusted and adjusted analyses showed that treatment did not improve initial cognitive outcomes or affect subsequent cognitive status 1 year later. LIMITATIONS: Cognitive assessments began after treatment was initiated; cognitive assessment was limited.
conclusionTreatment with high daily doses of B vitamins, which decreased tHcy levels, did not affect cognitive outcomes in patients with advanced CKD and ESRD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.