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A systematic review for the efficacy of coenzyme Q10 in patients with chronic kidney disease

Yongxing Xu, Guolei Yang, Xiaowen Zuo, Jianjun Gao, Huaping Jia, Enhong Han, Juan Liu, Yan Wang, Hong Yan
International Urology and Nephrology 2022 54(1):173-184

Bibliography

PubMed
PMID 33782820
DOI
10.1007/s11255-021-02838-2
Funding
No specific funding statement was identified in the accessible publication record.
Competing interests
No specific competing-interest statement was identified in the accessible publication record.

Study snapshot

DesignSystematic review with pooled analyses; MEDLINE, EMBASE and Cochrane CENTRAL searched for CoQ10 supplementation studies in CKD.
ModelPatients with chronic kidney disease across different stages and dialysis settings.
Sample12 independent studies represented by 17 publications.
InterventionCoQ10 supplementation versus placebo/control across heterogeneous CKD trials with varying doses, durations and populations.
DurationVaried across included studies.
EndpointsCardiovascular outcomes; Malondialdehyde; High-sensitivity CRP; HbA1c; QUICKI; Total cholesterol; LDL-C; HDL-C; Triglycerides

What the study showed, in plain terms

This systematic review identified 12 independent CKD studies published across 17 papers. Six studies reported cardiovascular outcomes, but those results were inconsistent rather than clearly beneficial.

Pooled biomarker analyses favored CoQ10 for malondialdehyde (WMD −1.15, 95% CI −1.48 to −0.81) and hs-CRP (WMD −1.18, 95% CI −2.21 to −0.15). Glycemic measures also improved: HbA1c WMD −0.80 (95% CI −1.35 to −0.24) and QUICKI WMD +0.02 (95% CI 0.01–0.03).

Pooled lipid outcomes were null for total cholesterol, LDL-C, HDL-C and triglycerides. Overall, the CKD literature suggests some antioxidant, inflammatory and glycemic biomarker effects, but it does not establish slower CKD progression, fewer dialysis events or a consistent cardiovascular benefit.

Key findings

  • Cardiovascular outcomes: six studies, inconsistent overall findings.
  • Malondialdehyde: WMD −1.15 (95% CI −1.48 to −0.81).
  • hs-CRP: WMD −1.18 (95% CI −2.21 to −0.15).
  • HbA1c: WMD −0.80 (95% CI −1.35 to −0.24).
  • QUICKI: WMD +0.02 (95% CI 0.01–0.03).
  • Total cholesterol, LDL-C, HDL-C and triglycerides: no significant pooled effects.

What this study can and cannot tell us

  • CKD populations, dialysis status, CoQ10 dose, treatment duration and outcome definitions varied across studies.
  • The clearest positive findings were surrogate laboratory markers; patient-important renal outcomes were sparse.
  • Cardiovascular findings were inconsistent, preventing a strong clinical cardiovascular conclusion for CKD patients.
  • A pooled biomarker improvement should not be interpreted as proof that CoQ10 slows CKD progression.

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Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction Dr. Amr Yasser, PhDCardiometabolic, Musculoskeletal, Gut & Bioavailability Dr. Abdulla Mostafa, PhDCellular Senescence, Neurological, Mitochondrial & Brain-Ageing Biology