Maintained Folic Acid Supplementation Reduces the Risk of Mortality in Continuous Ambulatory Peritoneal Dialysis Patients

Abstract

Background: The association between folic acid (FA) supplementation and mortality in continuous ambulatory peritoneal dialysis (CAPD) patients is unclear.

Methods: FA exposure was calculated as a percentage of cumulative duration of drug usage to total follow-up duration (FA%). A total of 1,358 patients were classified by a cutoff value of FA%. The association of FA with mortality was evaluated using Cox proportional hazards models.

Results: The cutoff value of FA% for predicting mortality was <34% at a median follow-up of 40.7 months. FA ≥34% was associated with decreased risk for all-cause (adjusted hazard ratios [HRs] 95% CI 0.64 [0.48-0.85] and cardiovascular mortality 0.67 (95% CI 0.47-0.97). Moreover, the adjusted HRs per 10% higher FA for all-cause and cardiovascular mortality were 0.925 (95% CI 0.879-0.973) and 0.926 (95% CI 0.869-0.988), respectively.

Conclusions: Longer period of FA supplementation led to a reduction in risk of both all-cause and cardiovascular mortality in CAPD patients.

Keywords: All-cause mortality; Cardiovascular mortality; Folic acid; Peritoneal dialysis.