Evidence map›Paper›PMID 41580678›Full record

Trial reportBMC nephrology2026

Efficacy of L-methylfolate and methylcobalamin in treating resistant hypertension associated with elevated serum homocysteine in hemodialysis patients.

Mohamed Sherif Salem, Noha Alaa Hamdy, Hesham Abdallah Elghoneimy, Hanan Ms El Gowelli

Registry-linked trialAbstract readClinical Trial, Phase IVRandomized Controlled Trial
In one paragraph

Trial report in BMC nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05807711 (Efficacy of L-methylfolate and Methylcobalamine in Treating Resistant Hypertension Associated With Elevated Serum Homocysteine in Hemodialysis Patients.), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05807711 phase4completednot on this map

Efficacy of L-methylfolate and Methylcobalamine in Treating Resistant Hypertension Associated With Elevated Serum Homocysteine in Hemodialysis Patients.

TypeinterventionalSponsorAlexandria UniversityRan2023 to 2024Enrolled51ConditionsEnd Stage Renal Disease, Hypertension, RenalArmsL-Methyl Folate and methylcobalamine
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Mohamed Sherif SalemClinical Pharmacy & Pharmacy Practice Department, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt.
Noha Alaa HamdyClinical Pharmacy & Pharmacy Practice Department, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt.
Hesham Abdallah ElghoneimyNephrology Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt. hesham.elghoneimy@alexmed.edu.eg.ORCID 0000-0002-9591-7297
Hanan Ms El GowelliPharmacology and Toxicology Department, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt. Dr_hanan_el_gowali@hotmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEnd-stage renal disease (ESRD) patients receiving hemodialysis are experiencing a considerable increase in the burden of cardiovascular diseases (CVDs). In this patient population, hypertension is a prevalent modifiable cardiovascular risk factor that is associated with poor prognosis. Resistant hypertension in dialysis patients is challenging to manage since some individuals do not respond to antihypertensive medications or volume control. Hyperhomocysteinemia is common among ESRD patients. "H-type hypertension" or hyperhomocysteinemia-associated hypertension refers to resistant hypertension with elevated cardiovascular risk. The current study examined the efficacy of methylfolate and methylcobalamin supplementation in reducing serum homocysteine levels and improving blood pressure (BP) control in ESRD patients with resistant hypertension on regular hemodialysis.

methodsThroughout the study, 51 ESRD patients with resistant hypertension were randomly allocated to receive either daily doses of L-methylfolate 800 mcg and methylcobalamin 1000 mcg capsule (intervention group) or no medication (control group). Serum homocysteine levels were measured twice: at baseline and three months later. In addition, average pre- and post-dialysis blood pressure readings were obtained at baseline, one month, two months, and three months.

resultsAfter three months, mean serum homocysteine levels were significantly lower than at the commencement of therapy (p = 0.035), nonetheless, control patients showed no significant difference. Between-group analysis found a statistically significant difference in the change in homocysteine levels among the two groups (p = 0.006). Furthermore, the treatment group had statistically significant lower pre- and post-dialysis blood pressure readings.

conclusionsA three-month supplementation with a combination of 800 mcg methylfolate and 1000 mcg methylcobalamin showed promise in lowering blood pressure and serum homocysteine levels in ESRD patients with resistant hypertension. These findings require additional exploration in larger studies.

trial registrationClinicalTrials.gov Identifier NCT05807711 registered on 20,230,329.

Indexed as

HomocysteineHyperhomocysteinemiaHypertensionKidney Failure, ChronicRenal DialysisTetrahydrofolatesVitamin B 12AgedAntihypertensive AgentsDrug ResistanceDrug Therapy, CombinationFemaleHumansMaleMiddle AgedTreatment Outcome5-methyltetrahydrofolateAntihypertensive AgentsHomocysteinemecobalaminTetrahydrofolatesVitamin B 12End-stage renal diseaseHyperhomocysteinemiaHypertensionL-methylfolateMethylcobalaminResistant hypertension

Identifiers

PMID41580678
PMCPMC12911211

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.