Treatment of Hyperlipemia in Diabetic Patients on Dialysis with a Physiological Substance

Abstract

Hyperlipemia is a very frequent complication of the diabetic patient on dialysis. There is difficulty of treatment with the diet, because the dietary restriction already imposed on these patients and the secondary effects and toxicity of the available drugs in uremics aggravate the problem. We have treated 22 diabetic patients on dialysis (8 on hemodialysis and 14 on continuous ambulatory peritoneal dialysis) suffering from hyperlipemia with pantethine, a physiological substance and coenzyme A precursor in the Krebs eycle. With the administration of an oral dose of 900mg/day we obtained a reduction of total cholesterol (275 ± 72 vs. 231 ± 54mg/dl; p < 0.001), very-low-density lipoprotein (VLDL)-cholesterol (66 ± 36 vs. 46 ± 18 mg/dl; p < 0.01) and triglycerides (332 ± 182 vs. 227 ± 90 mg/dl; p < 0.01) at 2 months. High-density lipoprotein (HDL)-cholesterol did not change, but the total cholesterol/HDL-cholesterol ratio decreased significantly (p < 0.05). Total cholesterol, VLDL and triglycerides showed a progressive and significant reduction at 4 and 6 months. No changes were observed in serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, uric acid, blood glucose and glycosylated hemoglobin. Gastric discomfort in 2 patients and pruritus in another one were the secondary effects related. Pantethine was shown to be a very effective hypolipemic agent in diabetic patients on dialysis with a great tolerance.

Long-Term Pantethine Treatment Counteracts Pathologic Gene Dysregulation and Decreases Alzheimer's Disease Pathogenesis in a Transgenic Mouse Model

“…Interestingly, although cystamine inhibits the glutamyl synthase that consequently blocks ROS scavenging, it reduces transglutaminase activity known to be associated with protein aggregates in AD brain and to trigger A oligomerization and aggregation (113). Noteworthy, no side effects of pantethine were reported (114,115). Thus, in case of clear clinical benefits of pantethine treatment, determining whether pantethine itself or one of its metabolites is responsible should not be a barrier to its use.…”

Elevated Cell-Specific Microparticles Are a Biological Marker for Cerebral Dysfunctions in Human Severe Malaria

“…Knock-out mice deficient for the abca1 gene that do not up-regulate MP production in response to vesiculation agonists, are fully protected against experimental CM and display normal levels of plasma MP when their wild type CM-susceptible littermates show the onset of the syndrome [7]. In addition, when treated with pantethine, a physiological substance and co-enzyme A precursor in the Krebs cycle, used in patients for its hypolipemic properties [18],[19],[20], infected mice are protected against experimental CM and do not show elevated levels of plasma MP as their non treated littermates do [17]. We had previously reported dramatically increased endothelial MP levels in the peripheral blood of Malawian children with malaria, and this increase was restricted to patients with CM [12].…”

Pantethine, a derivative of vitamin B5, favorably alters total, LDL and non-HDL cholesterol in low to moderate cardiovascular risk subjects eligible for statin therapy: a triple-blinded placebo and diet-controlled investigation

“…A clinical study of diabetic hyperlipidemic patients on dialysis, treated with 900 mg/day of pantethine reported decreases in TC, very-low density lipoprotein cholesterol (VLDL-C), and TG 33. Pantethine may be a safe and effective alternative treatment of hyperlipidemia in patients with health issues who are not eligible for statin therapy.…”

“…Pantethine is known to be safe and effective33 and has been used as a medicine in Japan for over 40 years. In the US, oral pantethine (Pantesin®; Daiichi Fine Chemical Co, Ltd, Toyama, Japan) has been available as a nutritional supplement since 1992.…”