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However, an effect of supplemental folic acid on two other biomarkers of inflammationtumor necrosis factor and interleukin-6was not observed.30 Chronic Kidney Disease An elevated plasma level of homocysteine is an independent risk factor for chronic kidney disease and is linked with declining kidney function as the disease progresses.31 Over 85% of patients with chronic kidney disease have hyperhomocysteinemia, and plasma homocysteine levels in patients with end-stage renal disease are three to five times higher than those of normal individuals.32 A significant increase in plasma homocysteine levels, from 12.9 mmol/L in stage 1 to 23.68 mmol/L in stages 4 through 5, was observed in 132 patients with chronic kidney disease.31 Within the kidney, homocysteineinduced inflammation and oxidative stress lead to elevated urinary albumin levels (microalbuminuria) and injury to the podocytes, the renal filtration cells