Beneficial and Adverse Effects of Vitamin E on the Kidney

Overview

Journal Front Physiol

Date 2023 Apr 3

PMID 37007997

Authors

Aldona Baltusnikiene

Inga Staneviciene

Eugene Jansen

Affiliations

Soon will be listed here.

Abstract

This article reviews the beneficial and adverse effects of high-dose vitamin E supplementation on the vitamin E status and renal function in human and rodent studies. The high doses of vitamin E, which can cause renal effects, were compared to upper limits of toxicity (UL) as established by various authorities worldwide. In recent mice studies with higher doses of vitamin E, several biomarkers of tissue toxicity and inflammation were found to be significantly elevated. In these biomarker studies, the severity of inflammation and the increased levels of the biomarkers are discussed together with the need to re-evaluate ULs, given the toxic effects of vitamin E on the kidney and emphasizing oxidative stress and inflammation. The controversy in the literature about vitamin E effects on the kidney is mainly caused by the dose-effects relations that do not give a clear view, neither in human nor animals studies. In addition, more recent studies on rodents with new biomarkers of oxidative stress and inflammation give new insights into possible mechanisms. In this review, the controversy is shown and an advice given on the vitamin E supplementation for renal health.

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References

Bendich A, MACHLIN L . Safety of oral intake of vitamin E. Am J Clin Nutr. 1988; 48(3):612-9. DOI: 10.1093/ajcn/48.3.612. View

Di Vincenzo A, Tana C, El Hadi H, Pagano C, Vettor R, Rossato M . Antioxidant, Anti-Inflammatory, and Metabolic Properties of Tocopherols and Tocotrienols: Clinical Implications for Vitamin E Supplementation in Diabetic Kidney Disease. Int J Mol Sci. 2019; 20(20). PMC: 6834186. DOI: 10.3390/ijms20205101. View

Galli F, Bonomini M, Bartolini D, Zatini L, Reboldi G, Marcantonini G . Vitamin E (Alpha-Tocopherol) Metabolism and Nutrition in Chronic Kidney Disease. Antioxidants (Basel). 2022; 11(5). PMC: 9137556. DOI: 10.3390/antiox11050989. View

Galli F, Azzi A, Birringer M, Cook-Mills J, Eggersdorfer M, Frank J . Vitamin E: Emerging aspects and new directions. Free Radic Biol Med. 2016; 102:16-36. DOI: 10.1016/j.freeradbiomed.2016.09.017. View

Axelsson J, Bergsten A, Qureshi A, Heimburger O, Barany P, Lonnqvist F . Elevated resistin levels in chronic kidney disease are associated with decreased glomerular filtration rate and inflammation, but not with insulin resistance. Kidney Int. 2006; 69(3):596-604. DOI: 10.1038/sj.ki.5000089. View

Hara A, Tsujiguchi H, Suzuki K, Suzuki F, Kasahara T, Oanh P . Gender difference in the association of dietary intake of antioxidant vitamins with kidney function in middle-aged and elderly Japanese. J Nutr Sci. 2021; 10:e2. PMC: 8057365. DOI: 10.1017/jns.2020.54. View

Boaz M, Smetana S, Weinstein T, Matas Z, Gafter U, Iaina A . Secondary prevention with antioxidants of cardiovascular disease in endstage renal disease (SPACE): randomised placebo-controlled trial. Lancet. 2000; 356(9237):1213-8. DOI: 10.1016/s0140-6736(00)02783-5. View

Yusuf S, Dagenais G, Pogue J, Bosch J, Sleight P . Vitamin E supplementation and cardiovascular events in high-risk patients. N Engl J Med. 2000; 342(3):154-60. DOI: 10.1056/NEJM200001203420302. View

Kovesdy C . Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl (2011). 2022; 12(1):7-11. PMC: 9073222. DOI: 10.1016/j.kisu.2021.11.003. View

10.

Cook-Mills J, McCary C . Isoforms of vitamin E differentially regulate inflammation. Endocr Metab Immune Disord Drug Targets. 2010; 10(4):348-66. PMC: 3271790. DOI: 10.2174/1871530311006040348. View

11.

Springett G, Husain K, Neuger A, Centeno B, Chen D, Hutchinson T . A Phase I Safety, Pharmacokinetic, and Pharmacodynamic Presurgical Trial of Vitamin E δ-tocotrienol in Patients with Pancreatic Ductal Neoplasia. EBioMedicine. 2016; 2(12):1987-95. PMC: 4703733. DOI: 10.1016/j.ebiom.2015.11.025. View

12.

Mann J, Lonn E, Yi Q, Gerstein H, Hoogwerf B, Pogue J . Effects of vitamin E on cardiovascular outcomes in people with mild-to-moderate renal insufficiency: results of the HOPE study. Kidney Int. 2004; 65(4):1375-80. DOI: 10.1111/j.1523-1755.2004.00513.x. View

13.

Vrolijk M, Opperhuizen A, Jansen E, Godschalk R, van Schooten F, Bast A . The shifting perception on antioxidants: the case of vitamin E and β-carotene. Redox Biol. 2015; 4:272-8. PMC: 4803796. DOI: 10.1016/j.redox.2014.12.017. View

14.

Manolescu B, Atanasiu V, Cercasov C, Stoian I, Oprea E, Busu C . So many options but one choice: the human body prefers alpha-tocopherol. A matter of stereochemistry. J Med Life. 2010; 1(4):376-82. PMC: 5654212. View

15.

Wagner K, Kamal-Eldin A, Elmadfa I . Gamma-tocopherol--an underestimated vitamin?. Ann Nutr Metab. 2004; 48(3):169-88. DOI: 10.1159/000079555. View

16.

WHELDON G, Bhatt A, Keller P, Hummler H . d,1-alpha-Tocopheryl acetate (vitamin E): a long term toxicity and carcinogenicity study in rats. Int J Vitam Nutr Res. 1983; 53(3):287-96. View

17.

Bursell S, Clermont A, Aiello L, Aiello L, Schlossman D, Feener E . High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes. Diabetes Care. 1999; 22(8):1245-51. DOI: 10.2337/diacare.22.8.1245. View

18.

Gad El-Hak H, ELaraby E, Hassan A, Abbas O . Study of the toxic effect and safety of vitamin E supplement in male albino rats after 30 days of repeated treatment. Heliyon. 2019; 5(10):e02645. PMC: 6812462. DOI: 10.1016/j.heliyon.2019.e02645. View

19.

Meydani S, Meydani M, Rall L, Morrow F, Blumberg J . Assessment of the safety of high-dose, short-term supplementation with vitamin E in healthy older adults. Am J Clin Nutr. 1994; 60(5):704-9. DOI: 10.1093/ajcn/60.5.704. View

20.

. Food Labeling: Revision of the Nutrition and Supplement Facts Labels. Final rule. Fed Regist. 2016; 81(103):33741-999. View