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Effect of Coenzyme Q10 on Biomarkers of Oxidative Stress and Cardiac Function in Hemodialysis Patients: The CoQ10 Biomarker Trial.
Am J Kidney Dis 2017; 69(3):389-399AJ

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.

Authors+Show Affiliations

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

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27927588

Citation

Rivara, Matthew B., et al. "Effect of Coenzyme Q10 On Biomarkers of Oxidative Stress and Cardiac Function in Hemodialysis Patients: the CoQ10 Biomarker Trial." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 69, no. 3, 2017, pp. 389-399.
Rivara MB, Yeung CK, Robinson-Cohen C, et al. Effect of Coenzyme Q10 on Biomarkers of Oxidative Stress and Cardiac Function in Hemodialysis Patients: The CoQ10 Biomarker Trial. Am J Kidney Dis. 2017;69(3):389-399.
Rivara, M. B., Yeung, C. K., Robinson-Cohen, C., Phillips, B. R., Ruzinski, J., Rock, D., ... Himmelfarb, J. (2017). Effect of Coenzyme Q10 on Biomarkers of Oxidative Stress and Cardiac Function in Hemodialysis Patients: The CoQ10 Biomarker Trial. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 69(3), pp. 389-399. doi:10.1053/j.ajkd.2016.08.041.
Rivara MB, et al. Effect of Coenzyme Q10 On Biomarkers of Oxidative Stress and Cardiac Function in Hemodialysis Patients: the CoQ10 Biomarker Trial. Am J Kidney Dis. 2017;69(3):389-399. PubMed PMID: 27927588.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of Coenzyme Q10 on Biomarkers of Oxidative Stress and Cardiac Function in Hemodialysis Patients: The CoQ10 Biomarker Trial. AU - Rivara,Matthew B, AU - Yeung,Catherine K, AU - Robinson-Cohen,Cassianne, AU - Phillips,Brian R, AU - Ruzinski,John, AU - Rock,Denise, AU - Linke,Lori, AU - Shen,Danny D, AU - Ikizler,T Alp, AU - Himmelfarb,Jonathan, Y1 - 2016/12/04/ PY - 2016/03/02/received PY - 2016/08/25/accepted PY - 2016/12/9/pubmed PY - 2017/6/2/medline PY - 2016/12/9/entrez KW - Oxidative stress KW - antioxidant KW - biomarker KW - cardiac function KW - cardiovascular risk KW - coenzyme Q(10) (CoQ(10)) KW - dietary supplement KW - end-stage renal disease (ESRD) KW - hemodialysis KW - predialysis blood pressure KW - randomized controlled trial SP - 389 EP - 399 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 69 IS - 3 N2 - 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. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/27927588/Effect_of_Coenzyme_Q10_on_Biomarkers_of_Oxidative_Stress_and Cardiac_Function_in_Hemodialysis_Patients:_The_CoQ10_Biomarker_Trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(16)30573-X DB - PRIME DP - Unbound Medicine ER -