Vitamin E Supplements Benefit Dialysis Patients

by | Feb 10, 2014 | 2013, Kidney Health, Vitamin E

Written by Greg Arnold, DC, CSCS. In a 16-week trial, supplementation with 60IU of tocopherols led to a 28.5% decrease in triacylglycerols (unhealthy dietary fats) and a 38% increase in HDL-C ( good cholesterol).

The National Institutes of Health estimate that 20 million Americans (1 in 10 American adults) have chronic kidney disease, which costs an average of $70,000 per patient to treat (1). One of the treatment options is dialysis, of which there are two types: hemodialysis (where treatment is done through your bloodstream (2)) and peritoneal dialysis (where treatment is done through your stomach (3)). Patients undergoing hemodialysis are prone to faster rates of blood vessel calcification (4, 5) which increases their risk of death from cardiovascular disease (6, 7).

Now a new study (8) suggests that vitamin E supplementation may benefit those on hemodialysis. The study involved 81 patients (43 men, 38 women) between the ages of 45 and 71 who were undergoing “chronic hemodialysis treatment” (no definition was provided for how long “chronic” is regarding the treatments). They were given either 330 IU of vitamin D (270 IU tocotrienols, 60 IU tocopherols) or a placebo pill (0.72 IU tocotrienols, 1.32 IU tocopherols) per day for 16 weeks. Blood samples were provided before the study began and at 12 and 16 weeks to measure for levels of inflammation, oxidative stress, and lipids.

By the end of the 16-week supplementation period, no significant benefits were seen regarding inflammation and oxidative stress in the vitamin E group versus the placebo group. What was significant, however, was vitamin E’s effect on lipid levels. Specifically, plasma triacylglycerols decreased by 21.6% in the vitamin E group at 12 weeks (144 to 113 picogram (pg)/deciliter, p = 0.032) and by 28.5% at 16 weeks (144 to 103 pg/dL, p = 0.072) with no changes in the placebo group. High-density lipoproteins increased by 50% in the vitamin E group at 12 weeks (42 to 63 mg/dL, p = 0.05) and by 38% at 16 weeks (42 to 58 mg/dL, p =0.05) compared to no changes in the placebo group.

Finally, those in the vitamin E group had 26.2% lower levels of activity of a protein called cholesterol-ester transfer protein (96 vs. 130 picomoles per microliter of plasma per hour, p = 0.001). This result is important, since cholesterol-ester transfer protein accelerates the transformation of high-density lipoprotein into very-low density lipoprotein (9), so a lower cholesterol-ester transfer protein activity will help maintain healthy levels of high-density lipoprotein.

For the researches, “[Vitamin E] supplementation improved lipid profiles in this study of maintenance hemo­dialysis patients” and recommend “A multi-centered trial to confirm these observations.”

Source: Daud, Zulfitri A. Mat, et al. “Vitamin E tocotrienol supplementation improves lipid profiles in chronic hemodialysis patients.” Vascular health and risk management 9 (2013): 747.

© 2013 Daud et al. Creative Commons Attribution – Non Commercial (unported, v3.0) License. http://creativecommons.org/licenses/by-nc/3.0/.

Posted February 10, 2014.

Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com

References:

  1. Data available on National Institutes of Health’s National Kidney and Urologic Diseases Information Clearinghouse.
  2. “Treatment Methods for Kidney Failure: hemodialysis” posted on the National Institutes of Health’s National Kidney and Urologic Diseases Information Clearinghouse website.
  3. “Treatment Methods for Kidney Failure: Peritoneal Dialysis” posted on the National Institutes of Health’s National Kidney and Urologic Diseases Information Clearinghouse website.
  4. Goodman WG, Goldin J, Kuizon BD et al. Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 2000; 342: 1478–1483.
  5. Shroff RC, McNair R, Figg N et al. Dialysis accelerates medial vascular calcification in part by triggering smooth muscle cell apoptosis. Circulation 2008; 118: 1748–1757.
  6. Blacher J, Guerin AP, Pannier B et al. Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease. Hypertension 2001; 38: 938–942.
  7. London GM, Guerin AP, Marchais SJ et al. Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant 2003; 18: 1731–1740.
  8. Daud ZA.  Vitamin E tocotrienol supplementation improves lipid profiles in chronic hemodialysis patients. Vasc Health Risk Manag 2013;9:747-61. doi: 10.2147/VHRM.S51710. Epub 2013 Nov 28.
  9. Vaziri ND, Navab M, Fogelman AM. HDL metabolism and activity in chronic kidney disease. Nat Rev Nephrol. 2010;6(5):287–296.