Alpha-Lipoic Acid and Kidney Patients

Alpha-Lipoic Acid and Kidney Patients

In an open-label, parallel-group study involving 16 patients (8 with severely reduced renal function, 8 with end-stage renal disease needing hemodialysis), the effect of renal function on the pharmacokinetics, metabolism, and safety and of alpha-lipoic acid (thioctic acid) was evaluated by comparing the pharmacokinetic parameters with those of a reference group of 8 healthy subjects. Alpha-lipoic acid 600 mg was administered orally once daily for 4 days, and the pharmacokinetic parameters were measured on days 1 and 4. The mean percentage of the administered dose excreted in urine as parent compound was 0.2 and 0.05 in healthy subjects and subjects with severely reduced renal function, respectively. Assuming a bioavailability of 30%, this represents 0.67% and 0.17% of the bioavailable amount of alpha-lipoic acid, respectively. The percentage of total urinary recovered amounts of alpha-lipoic acid and 5 of its metabolites was 12.0 on both days. The respective values for patients with severe kidney damage were 5.2% (day 1) and 6.4% (day 4). The total percentage of the administered dose removed by hemodialysis was 4.0 in patients with end-stage renal disease. Renal clearance of alpha-lipoic acid and its major metabolites, 6,8-bismethylthio-octanoic acid, 4,6-bismethylthio-hexanoic acid and 2,4-bismethylthio-butanoic acid, were significantly decreased in subjects with kidney damage compared to the reference group. Apparent total clearance of alpha-lipoic acid was poorly correlated with creatinine clearance. There is strong evidence that alpha-lipoic acid is mainly excreted by nonrenal mechanism or further degraded to smaller units in the catabolic process. The significantly increased area under the curve values of 4,6-bismethylthio-hexanoic acid and half-lives of 2,4-bismethylthio-butanoic acid on both days in patients with severely reduced function and end-stage renal disease were not considered to be clinically relevant. Although trough levels of both metabolites tend to increase slightly in these subjects, no accumulation effects were detected. We conclude that the pharmacokinetics of alpha-lipoic acid are not influenced by creatinine clearance and are unaffected in subjects with severely reduced kidney function or end-stage renal disease. Hemodialysis did not significantly contribute to the clearance of alpha-lipoic acid. Hence, dose adjustment of alpha-lipoic acid is not necessary in patients with renal dysfunction.

References

1.Teichert J, Tuemmers T, Achenbach H, Preiss C, Hermann R, Ruus P, Preiss R. Pharmacokinetics of alpha-lipoic Acid in subjects with severe kidney damage and end-stage renal disease. J Clin Pharmacol. 2005 Mar;45(3):313-28.

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Alpha-Lipoic Acid and Diabetes

A new study suggests that R-alpha lipoic acid (R-ALA) supplementation may be beneficial in some patients with types 2 diabetes.

Many earlier studies have shown that ALA may improve blood sugar levels among patients with type 2 diabetes.

In the study, 20 patients with type 2 diabetes were randomly assigned to receive either 200 milligrams of R-ALA three times daily (30 minutes before meals) or placebo for 91 days. Glycated hemoglobin (HbA1c) levels, which indicate how well diabetes is being controlled, were measured at the beginning and end of the study.

Some individuals experienced reductions in HbA1c and were able to reduce their antidiabetic medications. However, in general, HbA1c levels were similar between both groups.

However, this study is limited by its small sample sizes and short duration. Additional research is needed to understand how R-ALA may affect diabetes.

For more information about alpha-lipoic acid, please visit Natural Standard's Foods, Herbs & Supplements database.

References

1.Natural Standard: The Authority on Integrative Medicine. http://www.naturalstandard.com/

2.Wong EL, Sung RY, Leung TF, et al. Randomized, Double-Blind, Placebo-Controlled Trial of Herbal Therapy for Children with Asthma. J Altern Complement Med. 2009 Oct 12. View Abstract

http://www.depsyl.com/

http://back2basicnutrition.com/

http://bionutritionalresearch.olhblogspace.com/

Alpha-Lipoic Acid and Diabetes

A new study suggests that R-alpha lipoic acid (R-ALA) supplementation may be beneficial in some patients with types 2 diabetes.

Many earlier studies have shown that ALA may improve blood sugar levels among patients with type 2 diabetes.

In the study, 20 patients with type 2 diabetes were randomly assigned to receive either 200 milligrams of R-ALA three times daily (30 minutes before meals) or placebo for 91 days. Glycated hemoglobin (HbA1c) levels, which indicate how well diabetes is being controlled, were measured at the beginning and end of the study.

Some individuals experienced reductions in HbA1c and were able to reduce their antidiabetic medications. However, in general, HbA1c levels were similar between both groups.

However, this study is limited by its small sample sizes and short duration. Additional research is needed to understand how R-ALA may affect diabetes.

For more information about alpha-lipoic acid, please visit Natural Standard's Foods, Herbs & Supplements database.

References
Natural Standard: The Authority on Integrative Medicine. www.naturalstandard.com

Wong EL, Sung RY, Leung TF, et al. Randomized, Double-Blind, Placebo-Controlled Trial of Herbal Therapy for Children with Asthma. J Altern Complement Med. 2009 Oct 12. View Abstract

http://www.depsyl.com/

http://back2basicnutrition.com/

http://bionutritionalresearch.olhblogspace.com/