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There is a significant body of research, mostly from the 2000s, on the homocysteine-lowering benefits of B12 in patients with end-stage renal disease and who are on haemodialysis (HD), 80100% of whom have elevated homocysteine levels

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The primary reason B12 status can decline after gastric banding is reduced intake and tolerance of B12-rich foods

For probable revisions to the clinical regimen, we will need a broader study with more subjects, along with a component for clinical trials to track patient response