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

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

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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Biomarkers
  • Double-Blind Method
  • Female
  • Heart / physiopathology*
  • Humans
  • Kidney Failure, Chronic / metabolism
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Oxidative Stress / drug effects*
  • Pilot Projects
  • Renal Dialysis*
  • Ubiquinone / analogs & derivatives*
  • Ubiquinone / pharmacology

Substances

  • Biomarkers
  • Ubiquinone
  • coenzyme Q10