title: Vitamin B12 supplementation in end stage renal diseases: a systematic review.
abstract: BACKGROUND
  Hyperhomocysteinemia is a risk factor for cardiovascular disease particularly in patients with end stage renal disease (ESRD). Vitamin B12 supplementation on its own still remains as a controversial issue for clinicians in decreasing the level of homcysteine in this group of patients.
  
  
  METHODS
  Using all randomized controlled trials (RCTs), clinical trials and pre-post-trial studies found during January 1999 to March 2014, we conducted a systematic review which assessed the effects of vitamin B12 in decreasing homocysteine levels in patients with ESRD.
  
  
  RESULTS
  The findings of this study revealed that, overall, the greatest effect of B12 supplementation on decreasing homocysteine levels in patients with ESRDs occurred when it was combined with folate supplementation. It was also demonstrated that injection treatments might be more beneficial than oral intake treatments.
  
  
  CONCLUSIONS
  More rigorous studies are needed to draw a firm conclusion about B12 therapy and the level of homocyteine in patients with ESRD.
authors.affiliation: PhD in Nutrition, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. aminmar67@yahoo.com.
authors.forename: Maryam
authors.initials: M
authors.lastname: Amini
authors.affiliation: PhD, MSPH in Nutrition, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. k27666@yahoo.com.
authors.forename: Maryam
authors.initials: M
authors.lastname: Khosravi
authors.affiliation: MD, PhD. in Epidemiology, Associate Professor of Clinical Epidemiology, Endocrine Research Center (Firouzgar), Institute of Endocrinology & Metabolism, Iran University of Medical Sciences, Tehran, Iran. baradaran.hr@iums.ac.ir.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Baradaran
authors.affiliation: MSc. in Medical Library & Information Science, Endocrinology and Metabolism Research Institute, Iran University of Medical Sciences, Tehran, Iran. rashaatlasi@gmail.com.
authors.forename: Rasha
authors.initials: R
authors.lastname: Atlasi
keywords: Amino Acids; Hemodialysis; Homocysteine; Kidney; Kidney Failure; Renal Failure; Review; Vitamin B12