Vitamin B Therapy Adversely Affects Progression of Diabetic Nephropathy

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B vitamins given to lower homocysteinemia — and thereby to reduce renal and vascular complications of diabetes — don’t have the desired effect, according to a JAMA study.
Researchers randomized nearly 250 patients with diabetic nephropathy to either high-dose B vitamins or placebo. The study’s primary outcome measure was the change in glomerular filtration rate (GFR) between baseline and study’s end.
After a mean follow-up of 32 months, GFRs declined more, on average, in the treatment group than in the control group (16.5 vs. 10.7 mL/min). A composite outcome of myocardial infarction, stroke, revascularization, and all-cause mortality also favored controls. The need for dialysis did not differ between groups. Homocysteine values, however, were significantly lower in the treatment group.
Pointing to earlier studies showing no treatment benefit, the authors conclude that “it would be prudent to discourage the use of high-dose B vitamins as a homocysteine-lowering strategy.”
Source: JAMA article


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