Vitamin E treatment of focal segmental glomerulosclerosis: Results of an open-label study

Abstract

Experimental data indicate that excessive production of reactive oxygen molecules contributes to progressive renal injury and that treatment with antioxidants attenuates this damage. Therefore, we investigated whether vitamin E supplementation could ameliorate renal disease and reduce proteinuria in children with a variety of kidney disorders. Vitamin E, 200 IU twice daily, was administered orally to 11 children with focal segmental glomerulosclerosis (FSGS) (group A) and 9 patients with miscellaneous kidney diseases (group B) [Henoch-Schonlein purpura nephritis (n = 3), urinary tract anomalies (n = 2), non-specific immune complex glomerulonephritis (n = 2), IgA nephropathy (n = 1), and reflux nephropathy (n = 1)]. The duration of vitamin E treatment, when no other therapy was introduced, was 2.9 ± 0.4 months. Proteinuria was determined by measuring the protein:creatinine ratio (mg/mg) in an early morning urine specimen. In children with FSGS, administration of vitamin E lowered the protein:creatinine ratio in 10 of 11 patients from 9.7 ± 5.1 to 4.1 ± 1.1 (P < 0.005). In contrast, among children with miscellaneous renal diseases, vitamin E had no beneficial impact on urinary protein excretion-protein:creatinine ratio 2.5 ± 1.0 pre versus 2.4 ± 1.2 post antioxidant. Vitamin E supplementation had no effect on glomerular filtration rate, serum albumin, or cholesterol concentration in either group of patients. These findings suggest that reactive oxygen molecules may play a more-prominent role in causing renal injury in patients with FSGS than in other kidney disorders.