This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. A substance called homocysteine circulates in the blood of all people. People with elevated levels of homocysteine experience more frequent heart attacks and strokes compared with people with normal homocystine levels. Dietary supplementation with vitamins, including folic acid, can reduce blood levels of homocystine, but it is uncertain whether this reduction in homocysteine levels is accompanied by a reduction in the frequency of heart attack and stroke. The purpose of this study is to establish whether reducing homocysteine levels with dietary vitamin supplementation is beneficial in patients. This study will be undertaken in adult kidney transplant recipients who will be followed for five years. Because this population has a combination of both very high circulating homocysteine levels and an elevated incidence of heart attack and stroke compared with the general population of patients. Thus this study is predicted to be very safe and to have a high likelihood of establishing whether reduction of circulating homocysteine blood levels is a reasonable clinical practice. The study will include a control group receiving conventional vitamin supplements and a study group receiving the same supplemenets as well as additional homocysteine-lowering dosages of folic acid and vitamins B6 and B12. The frequency of heart attack and stroke will be compared between the two groups, and interpreted in light of the homocysteine blood levels.
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