Thabet Mohamed Alaa, Chan James C M
University of Alexandria, Alexandria, Egypt.
Pediatr Nephrol. 2006 Dec;21(12):1790-801. doi: 10.1007/s00467-006-0211-6. Epub 2006 Sep 21.
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.
对患有免疫球蛋白A(IgA)肾病、局灶节段性肾小球硬化症(FSGS)和I型糖尿病的儿童给予维生素E显示出改善病情进展的潜力。口服维生素E疗法可减轻慢性肾衰竭(CKF)患者的内皮功能障碍、脂质过氧化和氧化应激。此外,使用维生素E结合型血液透析器可减少血液透析(HD)患者的动脉粥样硬化改变、促红细胞生成素剂量和肌肉痉挛。然而,几项对照临床试验未能证明对研究对象的心血管和肾脏结局有有益影响。最近一份关于接受高剂量维生素E治疗的成年患者全因死亡率增加的报告引起了相当大的关注和争论。本文将对维生素E在肾脏治疗方案中的疗效和安全性的这些问题进行综述。