Is folic acid supplementation useful for chronic kidney disease?

Patients with chronic kidney disease have higher cardiovascular risk than general population, a fact that has been linked to high homocysteine levels. Folic acid supplementation can reduce homocysteine levels, which would reduce cardiovascular events. However, there is controversy about the clinical effects of this measure. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified six systematic reviews comprising 13 trials addressing the question of this article. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded folic acid supplementation does not reduce the risk of myocardial infarction or stroke in patients with chronic kidney disease, and might have no effect on mortality.