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To the Editor:We read with great interest the study by Bennett-Richards and colleagues1 that examined the effect of oral folic acid on total homocysteine concentrations and endothelial function in children with chronic renal failure (CRF). They found that folic acid supplementation for 8 weeks significantly reduced homocysteine concentrations and increased low-density lipoprotein lag times (indicating a reduction in susceptibility of low-density lipoprotein to oxidation). Despite these favorable effects of folic acid on parameters that are detrimental to endothelial function, however, there was no significant improvement in flow-mediated dilatation (FMD) compared with placebo.1 The authors suggested several explanations, including the inability to normalize homocysteine levels in …

Reduction of Total Homocysteine Levels by Oral Folic Acid Fails to Improve Endothelial Function in Children With Chronic Renal Failure