Vitamin E in renal therapeutic regimens

Abstract

Administration of vitamin E in children with immunoglobulin A (IgA) nephropathy, focal segmental glomerulosclerosis (FSGS) and type I diabetes demonstrated potential towards ameliorating progression. Oral vitamin E therapy reduced endothelial dysfunction, lipid peroxidation and oxidative stress in patients with chronic kidney failure (CKF). Moreover, the use of vitamin E-bonded hemodialyzers reduced atherosclerotic changes, erythropoietin dosage and muscular cramps in patients on hemodialysis (HD). However, several controlled clinical trials failed to document beneficial effects on the study subjects' cardiovascular and renal outcomes. A recent report of increased all-cause mortality in adult patients receiving high dose vitamin E therapy has caused considerable concern and debate. These issues regarding the efficacy and safety of vitamin E in renal therapeutic regimens will be reviewed in this article.

Nutritional and Safety Outcomes from an Open-Label Micronutrient Intervention for Pediatric Bipolar Spectrum Disorders

“…Concern about differential responses to vitamin E supplementation in children versus adults and healthy versus chronic disease status exists. Adult vitamin E supplementation study findings have shown an increase in all-cause mortality (meta-analysis; Miller et al 2005), a greater rate of cognitive decline in those with Alzheimer's disease (Galasko et al 2012), and a trend toward new cases of prostate cancer in men (Klein et al 2011). Thabet et al (2006 cite other studies including meta-analyses that did not confirm these concerns, providing data supporting safety of vitamin E for renal disease patients, especially in children.…”

“…Response versus worsening may depend upon the presence and degree of oxidative stress present, at least for those with Alzheimer's disease (Lloret et al 2009). Also, a coantioxidant may be necessary to reduce a-TC after oxidation to prevent generation of lipid radicals (Thabet et al 2006). Further study of the effects of supplemental vitamin E on brain function and illness are needed before it can be considered useful and/or safe in all populations and ages.…”

Protective Effect of Vitamin E on Formaldehyde-Induced Injuries in the Rat Kidney

“…Factors such as carboxyethyl hydroxychromans (CEHC) are water-soluble metabolites of vitamin E that have anti-inflammatory and antioxidant properties. These metabolites increase in progressive renal diseases and improve renal function (19). Given the protective role of vitamin E against oxidative damage in the kidney (21) and other study results, it has been accepted that vitamin E has antioxidant properties and elevates the levels of catalases in kidney tissue (11).…”

“…Vitamin E as a powerful antioxidant and is the first line of defense against the peroxidation of fatty acids in phospholipids of cell membranes (18). In addition, lipid peroxidation index in the presence of vitamin E reduces (19). Vitamin E is also a powerful antioxidant that maintains the permeability of fluidity of biological membranes and prevents them from demolition (19).…”

“…In addition, lipid peroxidation index in the presence of vitamin E reduces (19). Vitamin E is also a powerful antioxidant that maintains the permeability of fluidity of biological membranes and prevents them from demolition (19). Vitamin E may increase the expression of E-cadherin in kidney tissue and renal tubular basal membrane degradation can be improved (20).…”