Often referred to as vitamin Q, Coenzyme Q10 (CoQ10) is a fat-soluble nutrient involved in making energy. It is also known as ubiquinone and has a significant antioxidative function. The structure of CoQ10 is similar to that of vitamin K. We discussed the benefits of CoQ10 for kidney disease in a previous blog. People with CKD always need to consider safe doses of vitamins and minerals since their kidneys cannot effectively rid the body of waste. Today, we will focus on the medical studies that discuss safety and the ideal CoQ10 dosage for kidneys. You will also find out about the common medications that lower CoQ10 levels and why CoQ10 is vital for kidney health.
What is CoQ10?
CoQ10 is an essential part of the electron transport chain in the mitochondria. It is, therefore, crucial for energy production in the cells. It is abundant in the most metabolically active tissues, which include the heart, kidney, and liver. In fact, the concentration of CoQ10 in the kidneys is second only to the amount found in heart muscle. Deficiency in CoQ10 leads to insufficient electron transport, which leads to increased formation of reactive oxygen species (aka, oxidative stress). The body needs a certain amount of oxidative stress, but too much of it is harmful and is caused by an imbalance between free radicals and antioxidants. There are many other functions for CoQ10, but we will not have room to discuss them here.
CoQ10 and Kidneys: Why the Kidneys Need CoQ10
The kidneys filter waste products from the blood in two stages. The first involves the straining of a large amount of fluid through tiny blood vessels, called glomeruli. However, if the body does not reclaim most of that fluid (known as filtrate), the person will die of dehydration within a few hours. This is why the second stage is so important. In it, millions of tiny tubes in the kidney, called tubules, reclaim most of that filtrate.
About 90% of this retrieval process occurs in the first part of the kidney tubule, which is called the proximal tubule. The proximal tubules are also the site of excretion of many organic substances, medications, and uremic toxins. This process of retrieval and excretion by kidney cells requires a significant amount of energy, or ATP (adenosine triphosphate). This explains why the proximal tubules are so rich in mitochondria and CoQ10. Mitochondria are the powerhouses of the cells, and they manufacture the body’s energy currency, ATP.
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CoQ10 and Kidney Disease
A number of studies investigated CoQ10 and chronic kidney disease (CKD). In a small study of CoQ10 and kidney health from Comenius University Medical Center in Slovakia, plasma concentrations of CoQ10 were found to be decreased in patients with kidney disease. Despite that there was an obvious decrease in CoQ10 levels with decreasing kidney function in that study, it did not reach statistical significance due to the small number of patients tested. The author concluded that oxidative stress occurs very early in kidney disease. Decreased CoQ10 levels in CKD were also confirmed in another study. It also appears that the presence of hypertension worsens CoQ10 deficiency in CKD. In addition, our ability to produce CoQ10 internally decreases with aging.
Medications that deplete CoQ10
Several medications can lower the levels of CoQ10 in the body and these include:
- Statin drugs for cholesterol
- Fibric acid drugs for cholesterol
- Beta-blockers for high blood pressure
- Anti-depressant drugs such as amitriptyline
- Warfarin, a blood thinner
- Certain chemotherapy and HIV medications
Can CoQ10 Improve Kidney Function?
As mentioned above, the kidneys require a lot of energy production. The tubules are very sensitive to oxidative stress, which is common in kidney disease. Add to that the deficiency of CoQ10 that is noted in kidney disease. This makes CoQ10 a very attractive supplement to improve energy production and decrease oxidative stress in the kidneys.
There have been many studies evaluating the role of CoQ10 in CKD. CoQ10 was found to reduce total and LDL cholesterol in kidney patients. It was also found to decrease oxidative stress (by lowering malondialdehyde, a marker of oxidative stress).
Additionally, CoQ10 was found to improve blood pressure control. A CoQ10 dose of 200 mg daily was found to decrease systolic blood pressure by 11 mmHg and diastolic blood pressure by 7 mmHg. This was thought to be due to its improvement in nitric oxide balance leading to decreased constriction of blood vessels.
In addition, supplementation with CoQ10 has been found to improve endothelial function in patients with type 2 diabetes mellitus. Endothelial function refers to the function of cells lining the blood vessels. CoQ10 also improves cardiovascular outcomes in patients with or without kidney disease.
Finally, a CoQ10 supplement was even found to improve serum creatinine levels, which are a marker of kidney function. As kidney disease progresses, blood creatinine levels rise.
These studies show that the answer to the question “Is CoQ10 safe for kidneys?” is a resounding yes!
What is the Best CoQ10 Dosage for Kidney Health?
Studies that looked at CoQ10 dosage established its safety and tolerability in the normal population. Doses as high as 3,000 mg per day did not produce serious side effects in normal subjects. Gastrointestinal side effects were the most common. That means CoQ10 is generally safe for healthy people, even at unusually high doses.
In kidney disease, the doses that were studied ranged from 100-300 mg daily. It is, therefore, reasonable to target a dose of 200-300 mg daily split into three doses (100 mg three times a day). Since CoQ10 is fat-soluble, it is better absorbed along with the intake of fatty foods. As always, we recommend choosing high-quality supplements.
Serum CoQ10 levels are widely available and can be measured as part of routine bloodwork. A target blood level of CoQ10 of 4.1 micromol/L was found to be therapeutic. Studies also showed that blood mononuclear cells (a diverse mixture of immune cells) may be better for monitoring its levels.
The Bottom Line on CoQ10 Dosage and CKD
CoQ10 can be beneficial for patients with kidney disease. It may improve cholesterol levels and blood pressure control and decrease oxidative stress, as well as potentially improve renal function. A dose of 200-300 mg daily divided into three doses (100 mg three times a day) is recommended for patients with kidney disease. Consult with your integrative kidney specialist to customize your CoQ10 dosage, especially if you are on medications that deplete CoQ10.
