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A surprise finding: homocysteine is supposed to be a factor in vascular inflammation, but lowering hyperhomocysteinemia in patients with diabetic nephropathy actually accelerated the decline of  their GFRs. What gives? We have a conversation with Dr. J. David Spence, whose results were just published in JAMA. Interview-related link: JAMA paper on the effect of B vitamins on diabetic nephropathy News-related links: Clopidogrel suffers possible class-effect interference from PPIs BMJ paper on hyperemesis gravidarum across generations High-test flu vaccine guidance from ACIP Brain games and the lack of data supporting their effectiveness The post Podcast 85: B vitamins lower homocysteine levels, so why don’t they retard the progression of diabetic nephropathy? first appeared on Clinical Conversations.