IMPACT OF TOCOTRIENOL SUPPLEMENTATION ON RENAL FUNCTIONS AND LIPID PROFILES IN PATIENTS WITH KIDNEY DISEASES: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

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Abstract Title *

IMPACT OF TOCOTRIENOL SUPPLEMENTATION ON RENAL FUNCTIONS AND LIPID PROFILES IN PATIENTS WITH KIDNEY DISEASES: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

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Co-author 1

Omar Elkoumi omarelkoumi@gmail.com Suez University Faculty of Medicine Suez Egypt *

Co-author 2

Ahmed Elkoumi ahmedelkoumi@yahoo.com The Ministry of Health and Population Health Affairs Directorate of El Sharqeya El Sharqeya Egypt -

Co-author 3

Mariam Khaled Elbairy mariam.ksah@med.suezuni.edu.eg Suez University Faculty of Medicine Suez Egypt -

Co-author 4

Ayah Abdulgadir Abdulgadirayah@gmail.com University of Khartoum Faculty of Medicine Khartoum Sudan -

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Introduction

Kidney diseases, including glomerular, tubulointerstitial, and vascular disorders, as well as dialysis dependence, are linked to oxidative stress, inflammation, and dyslipidemia. Tocotrienols, vitamin E isomers, have been proposed as a potential therapeutic intervention, yet their clinical efficacy remains uncertain. This systematic review and meta-analysis evaluate the effects of tocotrienol supplementation on renal function and lipid profiles in patients with kidney diseases.

Methods

A systematic search of PubMed, Scopus, Web of Science, and Cochrane CENTRAL was conducted from inception to October 2025. Randomized controlled trials (RCTs) assessing tocotrienol supplementation in kidney disease patients compared to placebo were included. Meta-analysis was performed using a fixed-effects model, with pooled standardized mean differences (SMDs) and mean differences (MDs) with 95% confidence intervals (CIs).

Results

Four RCTs with 224 participants met the inclusion criteria. Tocotrienol supplementation significantly improved eGFR (MD = 4.13, 95% CI: 0.56 to 7.69, p = 0.02) and reduced serum creatinine levels (SMD = -0.42, 95% CI: -0.77 to -0.07, p = 0.02), both with low heterogeneity (I² = 0%). However, the reduction in urea was not statistically significant (SMD = -0.28, 95% CI: -0.63 to 0.07, p = 0.11). Tocotrienols significantly increased HDL (SMD = 0.64, 95% CI: 0.25 to 1.03, p = 0.001) and reduced LDL (SMD = -0.49, 95% CI: -0.87 to -0.11, p = 0.01). Triglyceride reduction was borderline significant (SMD = -0.38, 95% CI: -0.75 to 0.00, p = 0.05), while total cholesterol remained unchanged (SMD = -0.09, 95% CI: -0.47 to 0.28, p = 0.62).

Conclusion

Tocotrienol supplementation demonstrates renoprotective effects by improving eGFR and reducing serum creatinine levels in kidney disease patients. It also enhances lipid profiles by increasing HDL and lowering LDL. However, its effects on total cholesterol and triglycerides warrant further investigation in larger RCTs with longer follow-ups.
The 45th Annual Meeting of the Korean Society of Nephrology

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