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Am J Kidney Dis. 2017 Mar;69(3):389-399. doi: 10.1053/j.ajkd.2016.08.041. Epub 2016 Dec 4.

Effect of Coenzyme Q10 on Biomarkers of Oxidative Stress and Cardiac Function in Hemodialysis Patients: The CoQ10 Biomarker Trial.

Author information

1
Kidney Research Institute, Seattle, WA; Division of Nephrology, Department of Medicine, University of Washington, Seattle, WA.
2
Kidney Research Institute, Seattle, WA; Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA.
3
Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA.
4
Kidney Research Institute, Seattle, WA.
5
Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA; Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA.
6
Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
7
Kidney Research Institute, Seattle, WA; Division of Nephrology, Department of Medicine, University of Washington, Seattle, WA. Electronic address: jhimmelfarb@nephrology.washington.edu.

Abstract

BACKGROUND:

Oxidative stress is highly prevalent in patients with end-stage renal disease and is linked to excess cardiovascular risk. Identifying therapies that reduce oxidative stress has the potential to improve cardiovascular outcomes in patients undergoing maintenance dialysis.

STUDY DESIGN:

Placebo-controlled, 3-arm, double-blind, randomized, clinical trial.

SETTING & PARTICIPANTS:

65 patients undergoing thrice-weekly maintenance hemodialysis.

INTERVENTION:

Patients were randomly assigned in a 1:1:1 ratio to receive once-daily coenzyme Q10 (CoQ10; 600 or 1,200mg) or matching placebo for 4 months.

OUTCOMES:

The primary outcome was plasma oxidative stress, defined as plasma concentration of F2-isoprotanes. Secondary outcomes included levels of plasma isofurans, levels of cardiac biomarkers, predialysis blood pressure, and safety/tolerability.

MEASUREMENTS:

F2-isoprostanes and isofurans were measured as plasma markers of oxidative stress, and N-terminal pro-brain natriuretic peptide and troponin T were measured as cardiac biomarkers at baseline and 1, 2, and 4 months.

RESULTS:

Of 80 randomly assigned patients, 15 were excluded due to not completing at least 1 postbaseline study visit and 65 were included in the primary intention-to-treat analysis. No treatment-related major adverse events occurred. Daily treatment with 1,200mg, but not 600mg, of CoQ10 significantly reduced plasma F2-isoprostanes concentrations at 4 months compared to placebo (adjusted mean changes of -10.7 [95% CI, -7.1 to -14.3] pg/mL [P<0.001] and -8.3 [95% CI, -5.5 to -11.0] pg/mL [P=0.1], respectively). There were no significant effects of CoQ10 treatment on levels of plasma isofurans, cardiac biomarkers, or predialysis blood pressures.

LIMITATIONS:

Study not powered to detect small treatment effects; difference in baseline characteristics among randomized groups.

CONCLUSIONS:

In patients undergoing maintenance hemodialysis, daily supplementation with 1,200mg of CoQ10 is safe and results in a reduction in plasma concentrations of F2-isoprostanes, a marker of oxidative stress. Future studies are needed to determine whether CoQ10 supplementation improves clinical outcomes for patients undergoing maintenance hemodialysis.

KEYWORDS:

Oxidative stress; antioxidant; biomarker; cardiac function; cardiovascular risk; coenzyme Q(10) (CoQ(10)); dietary supplement; end-stage renal disease (ESRD); hemodialysis; predialysis blood pressure; randomized controlled trial

PMID:
27927588
PMCID:
PMC5616172
DOI:
10.1053/j.ajkd.2016.08.041
[Indexed for MEDLINE]
Free PMC Article

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