Related Experiment Videos

Vitamin E in renal therapeutic regiments

Mohamed Alaa Thabet1, James C M Chan

  • 1University of Alexandria, Alexandria, Egypt.

Pediatric Nephrology (Berlin, Germany)
|December 23, 2006
PubMed

Insights

Vitamin E shows potential in managing kidney diseases like IgA nephropathy and FSGS, reducing oxidative stress. However, its overall efficacy and safety, especially at high doses, require further investigation for renal patients.

Area of Science:

  • Nephrology
  • Nutritional Science
  • Clinical Medicine

Background:

  • Vitamin E administration in children with IgA nephropathy, FSGS, and type I diabetes suggested potential benefits.
  • Oral vitamin E therapy has been shown to reduce endothelial dysfunction, lipid peroxidation, and oxidative stress in chronic kidney failure (CKF) patients.
  • Vitamin E-bonded hemodialyzers may decrease atherosclerotic changes, erythropoietin dosage, and muscular cramps in hemodialysis (HD) patients.

Purpose of the Study:

  • To review the efficacy and safety of vitamin E in renal therapeutic regimens.
  • To discuss the conflicting evidence regarding vitamin E's benefits on cardiovascular and renal outcomes.
  • To address concerns about increased all-cause mortality associated with high-dose vitamin E therapy.

Main Methods:

  • Review of controlled clinical trials and recent reports on vitamin E in renal patients.
  • Analysis of studies investigating oral vitamin E and vitamin E-bonded hemodialyzers.
  • Examination of data on vitamin E's impact on oxidative stress, endothelial function, and patient mortality.

Main Results:

  • Some studies indicate vitamin E may ameliorate progression in specific pediatric kidney conditions and reduce markers of oxidative stress.
  • Controlled trials have failed to consistently demonstrate beneficial cardiovascular and renal outcomes.
  • A recent report linked high-dose vitamin E therapy to increased all-cause mortality in adults.

Conclusions:

  • The role of vitamin E in renal therapy presents a complex picture with potential localized benefits but uncertain overall efficacy and safety.
  • Further research is needed to clarify the risk-benefit profile of vitamin E, particularly high-dose regimens, in patients with kidney disease.
  • The conflicting findings necessitate careful consideration of vitamin E use in clinical practice for renal patients.

Related Concept Videos

Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
Renal Drug Excretion: Tubular Secretion01:28

Renal Drug Excretion: Tubular Secretion

Active tubular secretion is a robust, energy-demanding process that utilizes carrier systems to transport drugs into renal tubules. The active renal secretion systems include the organic anion transporter (OAT) for weak acids and the organic cation transporter (OCT) for weak bases. Structurally similar drugs can compete for the same transporter, potentially leading to drug accumulation and toxicity. However, this principle can be exploited therapeutically. One example is probenecid (Probalan),...
Renal Drug Excretion: Overview01:15

Renal Drug Excretion: Overview

As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules out...
Renal Drug Excretion: Tubular Reabsorption01:25

Renal Drug Excretion: Tubular Reabsorption

Tubular reabsorption, a process occurring post-glomerular filtration of drugs in the renal tubule, is a critical determinant of drug half-life. During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. This...