Trial of Nicotinamide Riboside and Co-enzyme Q10 in Chronic Kidney Disease

NCT ID: NCT03579693

Last Updated: 2023-01-10

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

26 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-14

Study Completion Date

2021-04-26

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Chronic kidney disease is associated with the loss of skeletal muscle mass and function. This process detrimentally impacts mobility, functional independence, and quality of life. Mounting evidence suggests that chronic kidney disease impairs skeletal muscle functioning by injuring mitochondria, the central energy producing units of cells.

Potential treatment options to restore mitochondrial function include aerobic and weight bearing exercise and medications that directly improve mitochondrial energetics. Unfortunately, exercise programs may be difficult to implement in people who have chronic diseases, such as kidney disease.. Coenzyme Q10 (coQ10) and nicotinamide riboside (NR) are naturally occurring supplements that can directly improve mitochondrial efficiency. Both compounds help mitochondria produce more energy while generating less waste.

The primary purpose of this study is to test whether coQ10 and NR can improve muscle function among people with chronic kidney disease. What we learn in this study may help us better understand the mechanisms of skeletal muscle impairment among people with kidney disease and ultimately improve their ability to be active and independent.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Sarcopenia (decreased muscle mass or function) is common in patients with chronic kidney disease (CKD) patients with direct impacts on their metabolic and clinical outcomes. Existing evidence and the investigator's preliminary data suggest that mitochondrial dysfunction is a key underlying mechanism of sarcopenia in CKD. However, the ability of treatments to modify mitochondrial functioning in CKD patients is unknown. Coenzyme Q10 (coQ10) and nicotinamide riboside (NR) are naturally occurring supplements that reduce oxidative stress and restore substrate delivery to mitochondria, respectively.

Both processes have the potential to increase mitochondrial energy production with direct consequences for many metabolic and physical processes, including:

* aerobic capacity
* work efficiency
* mitochondrial energetics
* fatigue
* physical function
* inflammation
* oxidative stress
* heart failure symptoms
* metabolomics

These outcomes will assessed in all study participants who enroll in the trial. Addressing these knowledge gaps is necessary to shed new light on the pathophysiology of sarcopenia in CKD and suggest future interventions that reduce morbidity and mortality.

This is a randomized, placebo-controlled, double-blind crossover trial of coQ10 and NR treatments. Participants will receive coQ10 (1000 mg daily), NR (1200 mg daily), or placebo each for six-weeks in random order with a 7-day washout between treatment periods. The primary outcomes are aerobic capacity and muscle work efficiency, measured during cycle ergometry.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Chronic Kidney Disease Sarcopenia Frailty

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Randomized, placebo-controlled, cross-over trial
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

CoQ10

Coenzyme Q10, 2 - 250 mg tablets twice a day (1000 mg total daily dose) for 6 weeks

Group Type ACTIVE_COMPARATOR

CoQ10

Intervention Type DIETARY_SUPPLEMENT

CoQ10 tablet

Nicotinamide riboside

Nicotinamide riboside, 1 - 600 mg tablet twice a day (1200 mg total daily dose) for 6 weeks

Group Type ACTIVE_COMPARATOR

Nicotinamide riboside

Intervention Type DIETARY_SUPPLEMENT

NR tablet

Placebo

Placebo, inactive sugar pill for 6 weeks

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DIETARY_SUPPLEMENT

Sugar pill designed to mimic coQ10 and NR

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

CoQ10

CoQ10 tablet

Intervention Type DIETARY_SUPPLEMENT

Nicotinamide riboside

NR tablet

Intervention Type DIETARY_SUPPLEMENT

Placebo

Sugar pill designed to mimic coQ10 and NR

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

coenzyme Q10 NR

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Chronic kidney disease, defined in this study as an estimated glomerular filtration rate (eGFR) of \<50ml/min/1.73m2 using the Chronic Kidney Disease Epidemiology Collaboration equation

Exclusion Criteria

* 6-minute walking distance \>500meters
* Pregnancy
* Receiving renal replacement therapy (dialysis or kidney transplantation)
* Expectation to start dialysis within 6 months
* Insulin dependent diabetes mellitus
* Severe anemia: hemoglobin \<8 g/dL
* Hyperkalemia: K \>5.7 mEq/L
* Weight \>300 lbs
* HIV
* End stage liver disease with cirrhosis
* Oxygen-dependent Chronic Obstructive Pulmonary Disease (COPD)
* Unable to walk unassisted from room to room in own house
* Institutionalization, or inability to consent
* Use of immunosuppressive medications (i.e. steroids, calcineurin inhibitors)
* Malignancy requiring active treatment or currently under surveillance (at the discretion of the investigator)
* Cardiac pacemaker
* Current participation in another interventional trial
* Non-English speaking
* Hospitalization for heart attack, stroke, or unstable cardiac chest pain within the previous 3 months (e.g. myocardial infarction, unstable angina, cerebrovascular accident)
* Any medical condition that the investigator feels would prevent the participant from safely completing the exercise-based outcome measurements.
* Baseline systolic blood pressure \>170 or diastolic blood pressure \>100
* Persistent or permanent uncontrolled arrhythmia (at the discretion of the investigator)
Minimum Eligible Age

30 Years

Maximum Eligible Age

79 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

University of Washington

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Bryan Kestenbaum

Professor, School of Medicine: Department of Medicine: Nephrology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Bryan Kestenbaum, MD

Role: PRINCIPAL_INVESTIGATOR

University of Washington

Baback Roshanravan, MD

Role: PRINCIPAL_INVESTIGATOR

University of Washington

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University of Washington

Seattle, Washington, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Ahmadi A, Valencia AP, Begue G, Norman JE, Fan S, Durbin-Johnson BP, Jenner BN, Campbell MD, Reyes G, Kapahi P, Himmelfarb J, de Boer IH, Marcinek DJ, Kestenbaum BR, Gamboa JL, Roshanravan B. A Pilot Trial of Nicotinamide Riboside and Coenzyme Q10 on Inflammation and Oxidative Stress in CKD. Clin J Am Soc Nephrol. 2025 Mar 1;20(3):346-357. doi: 10.2215/CJN.0000000624. Epub 2025 Jan 23.

Reference Type DERIVED
PMID: 39847432 (View on PubMed)

Ahmadi A, Begue G, Valencia AP, Norman JE, Lidgard B, Bennett BJ, Van Doren MP, Marcinek DJ, Fan S, Prince DK, Gamboa J, Himmelfarb J, de Boer IH, Kestenbaum BR, Roshanravan B. Randomized crossover clinical trial of coenzyme Q10 and nicotinamide riboside in chronic kidney disease. JCI Insight. 2023 Jun 8;8(11):e167274. doi: 10.1172/jci.insight.167274.

Reference Type DERIVED
PMID: 37159264 (View on PubMed)

Provided Documents

Download supplemental materials such as informed consent forms, study protocols, or participant manuals.

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

Access external resources that provide additional context or updates about the study.

https://kri.washington.edu

Website for the Kidney Research Institute at the University of Washington

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

R01DK101509

Identifier Type: NIH

Identifier Source: secondary_id

View Link

STUDY00004998

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

NR Supplementation and Exercise
NCT04907110 COMPLETED NA
Long-term COVID and Rehabilitation
NCT05373043 RECRUITING NA