Assessing the Effect of the Dietary Supplement Coenzyme Q10 on Biomarkers of Oxidative Stress, Systemic Inflammation, and Endothelial Function in Hemodialysis Patients
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Washington
- Enrollment
- 66
- Locations
- 1
- Primary Endpoint
- Change from Baseline in Oxidative Stress Status at 1 month
Study Overview
Brief Summary
The investigators believe that relieving the oxidative stress experienced by hemodialysis patients may help improve cardiovascular health.
In this study, the investigators hypothesize that administration of coenzyme Q10, as a targeted antioxidant therapy, will ameliorate the excessive oxidative stress experienced by hemodialysis patients. This will lead to improvements in biomarkers of:
- oxidative stress status
- inflammatory status
- endothelial dysfunction
Detailed Description
There are more than 400,000 patients receiving dialysis in the United States, and the investigators expect that this number will go up. For those on hemodialysis, cardiovascular disease (CVD) accounts for a large part of the health problems that these patients have. Cardiovascular problems come from damage to the heart or blood vessels.
At present, the investigators have no treatments proven to help prevent CVD in those on dialysis. For the general population, the investigators know about many factors that increase the risk of CVD, such as having a high level of "bad" cholesterol. But for people on dialysis, the investigators believe that there are other risk factors that are just as important in the development of CVD.
People on dialysis often have high blood levels of waste products. This is called "uremia". The investigators believe that uremia can set up chemical reactions in the blood which can lead to hardening of the arteries (atherosclerosis), an important part of CVD. Compounds called antioxidants, which stop the chemical reactions, may help prevent CVD.
Coenzyme Q10 is a naturally occurring compound in blood and tissues. It is also a readily available dietary supplement often used as an alternative to other medicines. It is a strong antioxidant. The investigators already know that blood levels of coenzyme Q10 are lower in hemodialysis patients. Because of this, it is important for us to find out if giving coenzyme Q10 to hemodialysis patients can help prevent CVD.
In addition, many people take medications called "statins" to help reduce risk for cardiovascular disease. The investigators know that statins can lower coenzyme Q10. It is important for us to know if hemodialysis patients taking statins have lower levels of coenzyme Q10. It may be that taking coenzyme Q10 could increase the good effects of statin medication in hemodialysis patients.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Factorial
- Primary Purpose
- Prevention
- Masking
- Triple (Participant, Care Provider, Investigator)
Eligibility Criteria
- Ages
- 18 Years to 85 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients with end-stage renal disease receiving thrice weekly hemodialysis
- •Age ≥ 18 or ≤ 85 years
- •Life expectancy greater than one year
- •Ability to understand and provide informed consent for participation in the study
Exclusion Criteria
- •History of poor adherence to hemodialysis or medical regimen
- •Prisoners, patients with significant mental illness, and other vulnerable populations
- •AIDS (HIV seropositivity is not an exclusion criteria)
- •Active malignancy excluding basal cell carcinoma of the skin
- •Gastrointestinal dysfunction requiring parenteral nutrition
- •History of functional kidney transplant < 6 months prior to study entry
- •Anticipated live donor kidney transplant
- •Patients taking vitamin E supplements > 60 IU/day, vitamin C > 150 mg/day or other antioxidant or nutritional supplements
- •Incident hemodialysis patients (defined as within 90 days of dialysis initiation)
- •Patients hospitalized for more than 5 days within the past 30 days.
- •Patients being dialyzed with a tunneled catheter as a temporary vascular access
- •Patients with a history of a major atherosclerotic event (defined as combined incidence of myocardial infarction, urgent target-vessel revascularization, coronary bypass surgery, and stroke) within six months
- •Pregnancy
Arms & Interventions
Coenzyme Q10 1200 mg
Intervention: Coenzyme Q10 (Dietary Supplement)
Placebo
Intervention: Placebo (Dietary Supplement)
Coenzyme Q10 600 mg
Intervention: Coenzyme Q10 (Dietary Supplement)
Outcomes
Primary Outcomes
Change from Baseline in Oxidative Stress Status at 1 month
Time Frame: 1 month
We will examine whether administration of coenzyme Q10 will ameliorate the excessive oxidative stress burden as evidenced by changes in serum biomarkers of oxidative stress at the 1-month visit.
Change from Baseline in Oxidative Stress Status at 2 months
Time Frame: 2 months
We will examine whether administration of coenzyme Q10 will ameliorate the excessive oxidative stress burden as evidenced by changes in serum biomarkers of oxidative stress at the 2-month visit.
Change from Baseline in Oxidative Stress Status at 4 months
Time Frame: 4 months
We will examine whether administration of coenzyme Q10 will ameliorate the excessive oxidative stress burden as evidenced by changes in serum biomarkers of oxidative stress at the 4-month visit.
Secondary Outcomes
- Change from Baseline in Inflammatory Status at 2 months(2 months)
- Change from Baseline in Endothelial Function at 4 months(4 months)
- Change from Baseline in Inflammatory Status at 4 months(4 months)
- Change from Baseline in Inflammatory Status at 1 month(1 month)
- Change from Baseline in Endothelial Function at 1 month(1 month)
- Change from Baseline in Endothelial Function at 2 months(2 months)
Investigators
Jonathan Himmelfarb
Professor
University of Washington