5-methyltetrahydrofolate Survival and Inflammation in ESRD Patients

Inclusion Criteria: * Hemodialysis patients with age \> 18 years on regular bicarbonate hemodialysis or hemodiafiltration treatment three times a week * Clinical stability at least three months before the study started * Cardiovascular disease assessment as presence/absence of hypertension, ischemic cardiac disease, cerebral and peripheral vascular disease, diabetes. * We will investigate coronary artery disease by determination of at least one of the following parameters: * previous documentation of acute myocardial infarction (laboratory or ECG modifications); * symptomatic CVD events in the clinical history confirmed by a positive treadmill test; * coronary artery stenosis more than 50% in one of the three major coronary vessels documented by an angiographic study. All patients with coronary artery disease will be examined by a treadmill test (thallium scan) or coronary angiographic exam before entering the study. * We will investigate cerebrovascular disease by one of the following criteria: * a previous ictus (ongoing clinical evidence of neurological deficit in the three months before the study beginning, confirmed by a TC scan, a nuclear magnetic resonance or a physician's record of clinical history); * carotid vessels stenosis more than 50% documented by a Doppler exam. * Peripheral vascular disease will be assessed by the evidence of claudication intermittence, previous vascular surgical procedure (including amputation for ischemic limb …