4.7 Article

Oral Coenzyme Q10 supplementation leads to better preservation of kidney function in steroid-resistant nephrotic syndrome due to primary Coenzyme Q10 deficiency

期刊

KIDNEY INTERNATIONAL
卷 102, 期 3, 页码 604-612

出版社

ELSEVIER SCIENCE INC
DOI: 10.1016/j.kint.2022.04.029

关键词

coenzyme Q(10); coenzyme Q(10) deficiency; COQ2; COQ6; COQ8B; CoQ(10); CoQ(10) supplementation therapy; end-stage kidney disease; ESKD; genetic kidney disease; hereditary; kidney survival; outcome; proteinuria reduction

资金

  1. European Renal Association (ERA)
  2. European Reference Network for Rare Kidney Diseases (ERKNet)
  3. PodoNet Network for Podocyte Disorders
  4. German (mitoNET) and European Networks for Mitochondrial Disorders (GENOMIT)
  5. European Union
  6. German Ministry of Education and Research
  7. PodoNet from the EU 7th Framework Programme (EURenOmics) [2012-305608]
  8. German Research Foundation [Scha 477/11-1]

向作者/读者索取更多资源

This study analyzed the effects of Coenzyme Q10 (CoQ(10)) supplementation on patients with primary CoQ(10) deficiency, showing a significant reduction in proteinuria and better preservation of kidney function.
Primary Coenzyme Q10 (CoQ(10)) deficiency is an ultra-rare disorder caused by defects in genes involved in CoQ(10) biosynthesis leading to multidrug-resistant nephrotic syndrome as the hallmark kidney manifestation. Promising early results have been reported anecdotally with oral CoQ(10) supplementation. However, the long-term efficacy and optimal prescription remain to be established. In a global effort, we collected and analyzed information from 116 patients who received CoQ(10) supplements for primary CoQ(10) deficiency due to biallelic pathogenic variants in either the COQ2, COQ6 or COQ8B genes. Median duration of follow up on treatment was two years. The effect of treatment on proteinuria was assessed, and kidney survival was analyzed in 41 patients younger than 18 years with chronic kidney disease stage 1-4 at the start of treatment compared with that of an untreated cohort matched by genotype, age, kidney function, and proteinuria. CoQ(10) supplementation was associated with a substantial and significant sustained reduction of proteinuria by 88% at 12 months. Complete remission of proteinuria was more frequently observed in COQ6 disease. CoQ(10) supplementation led to significantly better preservation of kidney function (5-year kidney failure-free survival 62% vs. 19%) with an improvement in general condition and neurological manifestations. Side effects of treatment were uncommon and mild. Thus, our findings indicate that all patients diagnosed with primary CoQ(10) deficiency should receive early and life-long CoQ(10) supplementation to decelerate the progression of kidney disease and prevent further damage to other organs.

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