Combination therapy with vitamins B6, B9 and B12 is a therapeutic intervention to decrease levels of plasma homocysteine and the risk of cardiovascular disease. However, a recent trial found that cosupplementation with these vitamins exacerbated the decline in renal function and increased the risk of vascular disease in patients with diabetic nephropathy. Confidence in this high-dose vitamin supplement is shaken.
Subscribe to Journal
Get full journal access for 1 year
only $4.92 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
House, A. A. et al. Effect of B-Vitamin therapy on progression of diabetic nephropathy: A randomized controlled trial. JAMA 303, 1603–1609 (2010).
Lonn, E. et al. Homocysteine lowering with folic acid and B vitamins in vascular disease. N. Engl. J. Med. 354, 1567–1577 (2006).
Jamison, R. L. et al. Effect of homocysteine lowering on mortality and vascular disease in advanced chronic kidney disease and end-stage renal disease: A randomized controlled trial. JAMA 298, 1163–1170 (2007).
Ebbing, M. et al. Cancer incidence and mortality after treatment with folic acid and vitamin B12. JAMA 302, 2119–2126 (2009).
Williams, M. E. et al. Effects of pyridoxamine in combined phase 2 studies of patients with type 1 and type 2 diabetes and overt nephropathy. Am. J. Nephrol. 27, 605–614 (2007).
Lajer, M. et al. Plasma concentration of asymmetric climethylarginine (ADMA) predicts cardiovascular morbidity and mortality in type 1 diabetic patients with diabetic nephropathy. Diabetes Care 31, 747–752 (2008).
Koyama, K. et al. Randomized controlled trial of the effect of short-term coadministration of methylcobalamin and folate on serum ADMA concentration in patients receiving long-term hemodialysis. Am. J. Kidney Dis. 55, 1069–1078 (2010).
Zhao, R., Gao, F. & Goldman, I. D. Reduced folate carrier transports thiamine monophosphate: an alternative route for thiamine delivery into mammalian cells. Am. J. Physiol. Cell Physiol. 282, C1512–C1517 (2002).
Thornalley, P. J. The potential role of thiamine (vitamin B1) in diabetic complications. Curr. Diabetes Rev. 1, 287–298 (2005).
Rabbani, N. et al. High dose thiamine therapy for patients with type 2 diabetes and microalbuminuria: a pilot randomised, double-blind, placebo-controlled study. Diabetologia 52, 208–212 (2009).
The authors thank Diabetes UK and the British Heart Foundation for supporting their research on diabetes mellitus and cardiovascular disease.
The authors declare an association with the following company: Merck Serono. P. J. Thornalley received a research grant from Merck Serono for the project “Epidemiological cross-sectional study on B-vitamin acid status in South-East Asian diabetic patients” conducted in 2008–2009. P. J. Thornalley and N. Rabbani have received speakers honoraria from Merck Serono.
About this article
Cite this article
Thornalley, P., Rabbani, N. Vitamin B6, B9 and B12 in diabetic nephropathy—beware. Nat Rev Endocrinol 6, 477–478 (2010). https://doi.org/10.1038/nrendo.2010.124
Diabetes & Metabolic Syndrome: Clinical Research & Reviews (2017)
Frontiers in Plant Science (2016)
Metabolomics uncovers the role of adipose tissue PDXK in adipogenesis and systemic insulin sensitivity
B-Vitamin Serum Concentrations Predicting Long-Term Overall and Stroke-Free Survival after Carotid Endarterectomy
Journal of Stroke and Cerebrovascular Diseases (2016)
Pharmacologic approaches against Advanced Glycation End Products (AGEs) in diabetic cardiovascular disease
Research in Cardiovascular Medicine (2015)