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


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.

SUBMITTER: Rivara MB 

PROVIDER: S-EPMC5616172 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

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Publications

Effect of Coenzyme Q<sub>10</sub> on Biomarkers of Oxidative Stress and Cardiac Function in Hemodialysis Patients: The CoQ<sub>10</sub> Biomarker Trial.

Rivara Matthew B MB   Yeung Catherine K CK   Robinson-Cohen Cassianne C   Phillips Brian R BR   Ruzinski John J   Rock Denise D   Linke Lori L   Shen Danny D DD   Ikizler T Alp TA   Himmelfarb Jonathan J  

American journal of kidney diseases : the official journal of the National Kidney Foundation 20161204 3


<h4>Background</h4>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.<h4>Study design</h4>Placebo-controlled, 3-arm, double-blind, randomized, clinical trial.<h4>Setting & participants</h4>65 patients undergoing thrice-weekly maintenance hemodialysis.<h4>Intervention</h4>Patient  ...[more]

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