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Reporting summary Further information on research design is available in the Nature Portfolio Reporting Summary linked to this article

In those with MTHFR gene variants, folate and folic acid metabolism is inhibited in such that the vitamin is not efficiently reduced to its active form, 5-methyl-tetrahydrofolate (5-MTHF)

For the Clinician: The Deeper Approach Functional medicine moves past symptom suppression into systems biology , where CKD is seen as the downstream expression of multi-organ dysfunction