coenzyme-q10 and Kidney-Failure--Chronic

The current study was conducted to determine the effects of coenzyme Q10 (CoQ10) supplementation on glycemic control and markers of lipid profiles risk in diabetic hemodialysis (HD) patients.. This randomized, double blind, placebo-controlled clinical trial was performed among 60 diabetic HD patients. Subjects were randomly allocated into two groups to take either 120 mg/day of CoQ10 supplements or placebo (n = 30 each group) for 12 weeks.. After 12 weeks of intervention, CoQ10 supplementation, compared with the placebo, resulted in a significant decrease in serum insulin concentrations (- 2.5 ± 4.0 vs. + 2.8 ± 5.3 µIU/mL, P < 0.001), homeostasis model of assessment-estimated insulin resistance (- 0.9 ± 2.1 vs. + 1.2 ± 3.0, P = 0.002), and significant increase in the quantitative insulin sensitivity check index (+ 0.009 ± 0.01 vs. - 0.02 ± 0.05, P = 0.003). In addition, a trend toward a greater decrease in serum triglycerides (- 5 ± 53 vs. + 17 ± 44, P = 0.078) and VLDL-cholesterol levels (- 0.9 ± 10 vs. + 3 ± 9, P = 0.078) was observed in the CoQ10 group compared to the placebo group. We did not observe any significant effect of CoQ10 supplementation on fasting glucose, HbA1c and other lipid profiles compared with the placebo.. Overall, our study supported that CoQ10 supplementation to diabetic HD patients for 12 weeks had beneficial effects on markers of insulin metabolism, but did not affect fasting glucose, HbA1c, and lipid profiles. Clinical registration http://www.irct.ir : IRCT2016081811763N30.

Topics: Adult; Aged; Blood Glucose; Diabetes Complications; Dietary Supplements; Double-Blind Method; Female; Glycated Hemoglobin; Humans; Insulin; Insulin Resistance; Kidney Failure, Chronic; Lipids; Male; Middle Aged; Renal Dialysis; Triglycerides; Ubiquinone; Vitamins

Coenzyme Q10 (CoQ10) supplementation improves mitochondrial coupling of respiration to oxidative phosphorylation, decreases superoxide production in endothelial cells, and may improve functional cardiac capacity in patients with congestive heart failure. There are no studies evaluating the safety, tolerability and efficacy of varying doses of CoQ10 in chronic hemodialysis patients, a population subject to increased oxidative stress.. We performed a dose escalation study to test the hypothesis that CoQ10 therapy is safe, well-tolerated, and improves biomarkers of oxidative stress in patients receiving hemodialysis therapy. Plasma concentrations of F2-isoprostanes and isofurans were measured to assess systemic oxidative stress and plasma CoQ10 concentrations were measured to determine dose, concentration and response relationships.. Fifteen of the 20 subjects completed the entire dose escalation sequence. Mean CoQ10 levels increased in a linear fashion from 704 ± 286 ng/mL at baseline to 4033 ± 1637 ng/mL, and plasma isofuran concentrations decreased from 141 ± 67.5 pg/mL at baseline to 72.2 ± 37.5 pg/mL at the completion of the study (P = 0.003 vs. baseline and P < 0.001 for the effect of dose escalation on isofurans). Plasma F2-isoprostane concentrations did not change during the study.. CoQ10 supplementation at doses as high as 1800 mg per day was safe in all subjects and well-tolerated in most. Short-term daily CoQ10 supplementation decreased plasma isofuran concentrations in a dose dependent manner. CoQ10 supplementation may improve mitochondrial function and decrease oxidative stress in patients receiving hemodialysis.. This clinical trial was registered on clinicaltrials.gov [NCT00908297] on May 21, 2009.

Topics: Administration, Oral; Adolescent; Adult; Aged; Aged, 80 and over; Dietary Supplements; Dose-Response Relationship, Drug; Drug Tolerance; Female; Humans; Kidney Failure, Chronic; Male; Maximum Allowable Concentration; Middle Aged; Oxidative Stress; Renal Dialysis; Ubiquinone; United States; Young Adult

Coenzyme Q10 (CoQ10) supplementation has been shown to improve diastolic heart function in various patient cohorts. Systolic and diastolic dysfunctions are common in patients with end-stage renal disease. Favorable effects of CoQ10 on cardiac functions are yet to be seen in hemodialysis patients. We aimed to evaluate effect of CoQ10 supplementation on diastolic function in a cohort of maintenance hemodialysis patients. This was a prospective, double-blind, placebo-controlled, crossover study in which all patients received placebo and oral CoQ10 200 mg/d during the 8 weeks in each phase, with a 4-week washout period. Participants underwent conventional and tissue Doppler echocardiography before and after each study phase. Parameters characterizing left ventricle diastolic function and other standard echocardiographic measurements were recorded. Twenty-eight patients were randomized, but 22 patients completed study protocol. Intraventricular septum (IVS) thickness and left ventricle mass were significantly decreased in CoQ10 group (P = 0.03 and P = 0.01, respectively). Myocardial peak systolic and early diastolic velocities derived from IVS were significantly increased (P = 0.048 and P = 0.04, respectively). Isovolumetric relaxation time and E/Em ratio calculated for IVS also significantly reduced in CoQ10 group (p = 0.02 and p = 0.04, respectively). There was no significant difference in any of the studied echocardiographic parameters in placebo group. The results of this study showed that CoQ10 supplementation did not significantly improved diastolic heart functions compared with placebo in maintenance hemodialysis patients.

Topics: Cohort Studies; Cross-Over Studies; Diastole; Double-Blind Method; Echocardiography, Doppler; Female; Heart; Humans; Kidney Failure, Chronic; Male; Middle Aged; Placebos; Prospective Studies; Renal Dialysis; Ubiquinone

Increased oxidative stress is associated with various complications in hemodialysis (HD) patients.. We examined the effect of coenzyme Q10 (CoQ10) administration on the plasma oxidative products and antioxidant capacity in 36 HD patients for 6 months.. The advanced oxidation protein products (AOPP), malondialdehyde and the percentage of ubiquinone in total CoQ10 were significantly higher in HD patients than in healthy subjects before administration (0 month). Oxygen radical absorbing capacity (ORAC) and Trolox equivalent antioxidant capacity (TEAC), indicators of total antioxidant capacity, were also paradoxically higher in the HD patients at 0 month. AOPP and the percentage of ubiquinone significantly decreased during CoQ10 administration, but increased again after the discontinuation. ORAC and TEAC were also decreased during CoQ10 administration.. The CoQ10 administration was partially effective for suppressing the oxidative stress in HD patients. The unexpected decrease of ORAC and TEAC by CoQ10 seemed to be associated with a decreased oxidative stress.

Topics: Aged; Antioxidants; Biomarkers; Case-Control Studies; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Oxidants; Oxidation-Reduction; Oxidative Stress; Renal Dialysis; Ubiquinone

Endothelial dysfunction is common in patients undergoing hemodialysis (HD). However, little is known about the relationship between endothelial dysfunction and coenzyme Q10 (CoQ10) levels in HD patients.. Eligible HD patients were enrolled in this study according to prespecified inclusion and exclusion criteria. Endothelial function was assessed by brachial artery flow-mediated dilation (FMD). Plasma CoQ10, serum malondialdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG) levels were measured. The potential confounders identified by univariate analyses (P < 0.15) were selected in a stepwise multiple regression model.. In total, 111 HD patients were enrolled in this study. The mean CoQ10 level was 633.53 ± 168.66 ng/mL, and endothelial dysfunction was prevalent (91.0%) using a cut-off value of 10% FMD. A significant correlation was observed between FMD and plasma CoQ10 level (r = 0.727, P < 0.001). After adjusting for potential parameters, a stepwise multivariate linear regression analysis revealed that CoQ10 level was an independent predictor of FMD (β = 0.018, P < 0.001). When CoQ10 was dichotomized using the median value (639.74 ng/mL), the conclusion remained unchanged (β = 0.584, P < 0.001). Pearson's correlation analyses revealed that plasma CoQ10 level was negatively correlated with MDA (r = -0.48, P < 0.001) and 8-OHdG (r = -0.43, P < 0.001) levels.. Our data demonstrate that impaired brachial artery FMD was common in HD patients. CoQ10 level was independently associated with FMD, and oxidative stress may constitute a link between CoQ10 level and endothelial dysfunction in these patients.

Topics: 8-Hydroxy-2'-Deoxyguanosine; Brachial Artery; Correlation of Data; Endothelium, Vascular; Female; Humans; Kidney Failure, Chronic; Male; Malondialdehyde; Middle Aged; Oxidative Stress; Renal Dialysis; Ubiquinone; Vasodilation

Primary coenzyme Q10 deficiency-6 (COQ10D6) is a rare autosomal recessive disorder caused by COQ6 mutations. The main clinical manifestations are infantile progressive nephrotic syndrome (NS) leading to end-stage renal disease and sensorineural deafness. A 7-year-old girl was diagnosed with steroid-resistant NS (SRNS) and an audiological work-up revealed bilateral sensorineural deafness. A renal biopsy demonstrated focal segmental glomerulosclerosis. Despite immunosuppressive therapy, her serum levels of creatinine increased and haemodialysis was indicated within 1 year after the diagnosis. Living-donor kidney transplantation was performed in the eighth month of haemodialysis. A diagnostic custom-designed panel-gene test including 30 genes for NS revealed homozygous c.1058C > A [rs397514479] in exon nine of COQ6. Her older brother, who had sensorineural hearing loss with no renal or neurological involvement, had the same mutation in homozygous form. COQ6 mutations should be considered not only in patients with SRNS with sensorineural hearing loss but also in patients with isolated sensorineural hearing loss with a family history of NS. The reported p.His174 variant of COQ8B was suggested to be a risk factor for secondary CoQ deficiency, while p.Arg174 appeared to improve the condition in a yeast model. Family segregation and the co-occurrence of biallelic p.Arg174 of COQ8B in a brother with hearing loss implied that the interaction of the altered COQ8B with the mutant COQ6 alleviated the symptoms in this family. CoQ10 replacement therapy should be initiated for these patients, as primary CoQ10 deficiency is considered the only known treatable mitochondrial disease.

Topics: Ataxia; Child; Female; Homozygote; Humans; Kidney; Kidney Failure, Chronic; Male; Mitochondrial Diseases; Muscle Weakness; Mutation; Nephrotic Syndrome; Phenotype; Siblings; Ubiquinone

Topics: Female; Heart; Humans; Kidney Failure, Chronic; Male; Renal Dialysis; Ubiquinone

Oxidative stress results from an imbalance between the production of free radicals and antioxidant activity. There is wide agreement that patients undergoing regular dialysis treatment experience increased oxidative stress. The aim of this study was to investigate serum total antioxidant status (TAS), total oxidant status (TOS), ischemia-modified albumin (IMA), and coenzyme Q10 (CoQ10) levels in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients, compared with controls.. This study was performed on 41 (21 men, 20 women) CAPD patients, 38 (20 men,18 women) HD patients, and 43 (23 men, 20 women) healthy control subjects. CoQ10 levels were standardized using blood lipids.. Serum TAS levels and CoQ10/total cholesterol values of the HD and CAPD patients were significantly lower, whereas serum IMA and TOS levels were significantly higher, than those of controls. Furthermore, CoQ10/LDL, CoQ10/triglycerides, and CoQ10/total cholesterol + triglycerides values of the CAPD patients were significantly lower than those of controls. No differences were found between serum IMA, TAS, TOS, CoQ10 levels, and adjusted CoQ10 values of the CAPD and HD patients.. Our results suggest that oxidative stress is increased in HD and CAPD patients compared with controls, as proven by decreased TAS and adjusted CoQ10 levels and increased TOS and IMA levels. Therefore, an antioxidant supplementation to these patients may be suggested.

Topics: Adult; Aged; Biomarkers; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Oxidative Stress; Peritoneal Dialysis; Renal Dialysis; Serum Albumin; Serum Albumin, Human; Ubiquinone

The aim of this study was to evaluate the renal preservation effect of ubiquinol, the reduced form of coenzyme Q10 (CoQ10).. Three-week-old heminephrectomized male Sprague-Dawley rats were divided into three groups (10 animals each): diet with normal (0.3%) salt, high (8%) salt, and high salt plus 600 mg/kg body weight/day of ubiquinol, for 4 weeks. Systolic blood pressure (SBP), urinary albumin (u-alb), superoxide anion generation (lucigenin chemiluminescence) and ubiquinol levels in renal tissues were examined.. Salt loading increased SBP (111.0 ± 3.6 vs. 169.4 ± 14.3 mmHg, p < 0.01) and u-alb (43.8 ± 28.0 vs. 2528.7 ± 1379.0 µg/day, p < 0.02). These changes were associated with stimulation of superoxide generation in the kidney (866.3 ± 102.8 vs. 2721.4 ± 973.3 RLU/g kidney, p < 0.01). However, ubiquinol decreased SBP (143.9 ± 29.0 mmHg, p < 0.05), u-alb (256.1 ± 122.1 µg/day, p < 0.02), and renal superoxide production (877.8 ± 195.6 RLU/g kidney, p < 0.01), associated with an increase in renal ubiquinol levels.. Ubiquinol, the reduced form of CoQ10, effectively ameliorates renal function, probably due to its antioxidant effect. Thus, ubiquinol may be a candidate for the treatment of patients with kidney disease.

Topics: Animals; Antioxidants; Humans; Kidney; Kidney Failure, Chronic; Male; Oxidative Stress; Rats; Rats, Sprague-Dawley; Sodium, Dietary; Ubiquinone

Oxidative stress is increased in chronic kidney disease (CKD) patients and end-stage renal disease (ESRD) patients undergoing dialysis treatment. Coenzyme Q(10) (CoQ(10)) is a ubiquitous and strong antioxidant. Role of CoQ(10) is not fully evaluated in renal patients. We aimed to investigate the relationship of CoQ(10) with oxidant and antioxidant system markers in patients with renal disease.. Forty patients with CKD (stages 3-5) who were managed conservatively without dialysis treatment, 40 hemodialysis, and 60 chronic ambulatory peritoneal dialysis (CAPD) patients were included in the study. Biochemical and whole blood analyses were done using hospital auto-analyzers from stored samples. Serum CoQ(10), malondialdehyde (MDA), superoxide dismutase (SOD), and antioxidant activity (AOA) levels were determined.. There was no difference among the groups in terms of serum CoQ(10) levels. However, other components of antioxidant system, namely, SOD and AOA were significantly higher in CAPD patients when compared to CKD patients. MDA levels were not significantly different among the groups. PRINCIPAL CONCLUSION(S): The results of this study showed no difference among CKD, CAPD, and hemodialysis patients in terms of serum CoQ(10) levels.

Topics: Antioxidants; Biomarkers; Cohort Studies; Cross-Sectional Studies; Humans; Kidney Failure, Chronic; Middle Aged; Oxidative Stress; Peritoneal Dialysis; Renal Dialysis; Superoxide Dismutase; Ubiquinone

Topics: Alkyl and Aryl Transferases; Female; Humans; Infant; Kidney Failure, Chronic; Male; Mitochondrial Encephalomyopathies; Mutation, Missense; Nephrotic Syndrome; Proteinuria; Ubiquinone

Topics: beta Carotene; Coenzymes; Creatinine; Humans; Kidney Failure, Chronic; Malondialdehyde; Oxidative Stress; Ubiquinone; Vitamin E

Coenzyme Q10 (CoQ10), vitamin E, triglycerides and conjugated dienes were measured in a group of 48 patients on chronic hemodialysis, in 15 uremic patients and in a control group of 10 normal subjects. CoQ10 levels were significantly lower (P < 0.001) in both hemodialytic and uremic patients compared with the normal group whereas triglycerides were significantly higher (P < 0.001) with respect to both normal subjects and uremic patients. Conjugated dienes were significantly higher (P < 0.001) in both hemodialytic and uremic patients with respect to normal subjects. The predialytic values of vitamin E were higher in hemodialytic patients with respect to both normal subjects and uremic patients whereas the postdialytic values were in the normal range. A restoration mechanism of vitamin E after hemodialytic treatment was hypothesized.

Topics: Adult; Aged; Coenzymes; Humans; Kidney Failure, Chronic; Lipid Peroxidation; Lipids; Middle Aged; Renal Dialysis; Triglycerides; Ubiquinone; Uremia; Vitamin E