Effect of vitamin E on lipid metabolism and atherosclerosis in ESRD patients

Mune, Masatoshi; Yukawa, Susumu; Kishino, Masanori; Otani, Haruhisa; Kimura, Keigo; Nishikawa, Osamu; Takahashi, Toshio; Kodama, Naoya; Saika, Yasushi; Yamada, Yoichi

doi:10.1016/s0085-2538(15)46619-0

Cited by 72 publications

(36 citation statements)

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“…Indeed, we were unable to detect any vitamin E increase both in plasma and in LDL after 3 or 6 months of treatment. These results are in total agreement with very recent findings from Yang et al [33] or those from Mune et al [34] who also did not observe any increase in plasma vitamin E after 12 months of treatment. However, the latter authors reported a reduction in oxidized LDL (i) after 6 and 18 months for the post HD levels and (ii) after 24 months for the pre-HD levels with use of vitamin E-coated membrane compared to regenerated cellulose.…”

Section: Discussionsupporting

confidence: 93%

Regional Variations of Low-Density Lipoprotein Oxidizability in Hemodialysis Patients May Explain Discrepancies in Interventional Therapy on Oxidative Profile

Moréna¹,

Gausson

Mothu

et al. 2008

Blood Purif

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Background/Aims: This study aimed at evaluating oxidative stress (OS) markers (i) in a cross-sectional study of hemodialysis (HD) patients to investigate potential regional effects of these markers and (ii) in a prospective crossover study to evaluate vitamin E-coated membrane (VE) effects. Methods: At baseline, OS parameters including low-density lipoprotein (LDL) oxidizability were measured in HD patients from five dialysis facilities. Patients were then randomly assigned to two treatment groups: group I patients (n = 33) switching to VE, and group II patients (n = 29) still using reference polysulfone (PS) membrane. After 3 months, patients were switched from VE to PS and vice versa for 6 months. The same OS parameters were measured after each period. Results: At baseline, the cross-sectional analysis of LDL oxidizability showed a regional effect. By contrast, the crossover study did not show beneficial effects of VE on this parameter. Conclusion: Regional variations of LDL oxidizability in HD patients exist and may explain discrepancies in interventional therapy on OS.

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Section: Discussionsupporting

confidence: 93%

Regional Variations of Low-Density Lipoprotein Oxidizability in Hemodialysis Patients May Explain Discrepancies in Interventional Therapy on Oxidative Profile

Moréna¹,

Gausson

Mothu

et al. 2008

Blood Purif

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“…A modest inverse correlation was also noted between Ox-LDL levels and percent increase in flow mediated vasodilatation. The current data are consistent with several studies showing long term, but not acute, reductions in circulating OxLDL in patients undergoing hemodialysis with vitamin E-coated membranes [27][28][29][30] . Consistent with this, one of the few positive randomized trials of oral vitamin E has been performed in hemodialysis patients, where a major reduction in myocardial infarction and major cardiovascular events was shown over a median follow-up of almost 2 years [31] .…”

Section: Discussionsupporting

confidence: 92%

Oxidized Low-Density Lipoprotein Biomarkers in Patients with End-Stage Renal Failure: Acute Effects of Hemodialysis

Bossola

Tazza²,

Merki³

et al. 2007

Blood Purif

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Objective: To assess the effect of end-stage renal failure on oxidized low-density lipoprotein (OxLDL) biomarkers and the acute effects of hemodialysis. Oxidized phospholipids (OxPL) on apolipoprotein B-100 (apoB) particles (OxPL/apoB) have been associated with cardiovascular disease and new cardiovascular events. Patients with end-stage renal failure have increased oxidative stress and are at significantly increased risk of cardiovascular disease. Methods and Results: Fifty-two stable patients with end-stage renal failure undergoing chronic hemodialysis were included in the study. Pre and post hemodialysis blood samples were obtained for measurement of OxLDL biomarkers: oxidized phospholipids (OxPL) on apolipoprotein B-100 (apoB) particles (OxPL/apoB) measured by antibody E06, IgG and IgM autoantibody titers to copper-oxidized LDL (Cu-OxLDL) and malondialdehyde (MDA)-LDL, IgG and IgM apolipoprotein B-100-immune complexes (IC/apoB). Traditional laboratory variables as well as C-reactive protein (CRP) and lipoprotein(a) [Lp(a)] were also measured. For the baseline variables, the distribution of OxPL/apoB and Lp(a) were skewed to lower values, and a strong correlation was noted between OxPL/apoB and Lp(a) (r = 0.94, p < 0.0001). No major associations were noted between OxLDL biomarkers and age, gender or dialytic age. There were also no correlations between OxLDL biomarkers and traditional risk factors, CRP, body mass index, serum creatinine, hypertension or intravenous iron therapy. Following dialysis, there as a significant reduction in OxPL/apoB (–7.5%, p = 0.048) and triglyceride levels (–10.8%, p = 0.005). All other OxLDL biomarkers, CRP, total cholesterol, LDL-C, HDL-C and apoB-100 increased significantly (range 6.3–26.9%, p value range 0.005 to <0.0001). Total protein plasma levels increased 8.8% (p = 0.014 compared to predialysis) following dialysis, consistent with a hemoconcentration effect of hemodialysis. Conclusion: In end-stage renal failure patients undergoing hemodialysis, a reduction in OxPL/apoB levels was noted, despite the hemoconcentrating and strong pro-oxidant milieu of hemodialysis. Studies in larger populations of end-stage renal failure patients are needed to assess whether these findings predict future clinical outcomes.

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“…Two small randomized trials that used vitamin E (49) and N-acetylcysteine (50), respectively, showed a decrease in cardiovascular events, although total mortality was not affected significantly. Hemodialysis using a vitamin E-coated membrane resulted in the reduction of serum oxidized LDL levels and an attenuation of the increase in aortic calcification index (51). Increasing serum HDL cholesterol by regular exer-cise is a sensible therapeutic approach, but dietary manipulation of serum lipids needs to take into account its potential for promoting malnutrition.…”

Section: Considerations For Treatment Of Dyslipidemia In Dialysis Patmentioning

confidence: 99%

Is Lipid Control Necessary in Hemodialysis Patients?

Cheung

2009

Clinical Journal of the American Society of Nephrology

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Although high serum total cholesterol and LDL cholesterol levels are predictive of cardiovascular diseases in the general population, this association is more complex in the dialysis patients. Two recent randomized trials failed to show significant beneficial effects of statins on the primary cardiovascular outcomes in these patients. The reasons for this lack of benefits are unclear. The postulates include the possibilities that LDL cholesterol is not important in atherogenesis and that atherosclerosis is not a major contributor to cardiovascular diseases in the dialysis population. It is important to note that high serum LDL cholesterol level is not a prominent feature of uremic dyslipidemia. Instead, the hallmark dyslipidemias in the dialysis population are hypertriglyceridemia as a result of the accumulation of lipoprotein remnant particles, low serum HDL cholesterol levels, high serum levels of lipoprotein(a) [Lp(a)], and the modification of LDL cholesterol by oxidation and carbamylation. In vitro and epidemiologic studies have further suggested that these abnormal lipoproteins or aberrant serum lipoprotein levels are atherogenic. More research efforts should be directed toward these dyslipidemic states and the multitude of other putative cardiovascular risk factors in dialysis patients.Clin J Am Soc Nephrol 4: S95-S101, 2009. doi: 10.2215/CJN.04780709 Hypercholesterolemia as a Cardiovascular Risk Factor in the General PopulationHypercholesterolemia is a well-established cardiovascular risk factor in the general population. The available literature, however, has suggested that the relationship of serum total cholesterol level with mortality and cardiovascular events in the long-term dialysis population is different (1). This article is a limited review on serum lipids in the general population and the results of two recent randomized trials on statins on clinical outcomes in hemodialysis patients, followed by considerations for clinical practice based on the interpretation of these data by the author.In the Multiple Risk Factor Intervention Trial (MRFIT), the risks for 6-yr mortality associated with serum total cholesterol levels were analyzed in 361,662 men aged 35 to 57 yr (2). Above the serum cholesterol level of 181 mg/dl, coronary heart disease mortality increased progressively, with a relative risk (RR) of 3.8 in men with cholesterol levels Ͼ253 mg/dl. The risk seemed to decrease with lowering of serum cholesterol to levels below approximately 140 mg/dl. This landmark epidemiologic study has formed a sound basis for many subsequent randomized trials to lower serum cholesterol, especially during the statin era. In a meta-analysis of 164 trials, various preparations of statins lowered serum total cholesterol levels by 30 to 60% or a mean of 70 mg/dl (3). Concomitant to this reduction in serum total cholesterol levels was a substantial reduction in the risk of ischemic heart disease by 60% in a meta-analysis of 58 trials. Pharmacotherapy using serum LDL cholesterol level as the target also shows benefici...

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Effect of vitamin E on lipid metabolism and atherosclerosis in ESRD patients

Cited by 72 publications

References 0 publications

Regional Variations of Low-Density Lipoprotein Oxidizability in Hemodialysis Patients May Explain Discrepancies in Interventional Therapy on Oxidative Profile

Regional Variations of Low-Density Lipoprotein Oxidizability in Hemodialysis Patients May Explain Discrepancies in Interventional Therapy on Oxidative Profile

Oxidized Low-Density Lipoprotein Biomarkers in Patients with End-Stage Renal Failure: Acute Effects of Hemodialysis

Is Lipid Control Necessary in Hemodialysis Patients?

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