Effects of Alpha-Lipoic Acid Supplementation on Weight Loss, Inflammatory, Lipid and Hematological Levels in Patients with CKD: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials.

Background and aims: The effects of alpha-lipoic acid (ALA) supplementation on cardiovascular-related factors have been evaluated in a number of randomized clinical trials (RCTs), with different results. Thus, in this meta-analysis, the effects of ALA on blood levels of inflammatory, lipid, and hematological markers as well as anthropometric indices in patients with chronic kidney disease (CKD) were evaluated.

Methods: Five electronic databases were used to conduct a comprehensive search through October 2023. Risk of bias assessment and data extraction were carried out separately by two reviewers on the included papers. The data were analyzed using the random-effects model in meta-analyses. The data were analyzed using the random-effects model in meta-analyses. We assessed inter-study heterogeneity with I² and Cochran's Q test.

Results: Nine of the 421 potential reports were included. Using random-effects models, no significant changes were observed in weight loss, body mass index (BMI), hemoglobin (Hb), and iron (Fe) following ALA supplementation (600 mg/day). Results exhibited that ALA significantly reduced hs-CRP levels in individuals with CKD (weighted mean difference (WMD) = -2.91 mg/L, 95% CI: -4.65, -1.17, I² = 50.5%, P = 0.09), however, there were no significant variations in levels of interleukin-6 (IL-6) or malondialdehyde (MDA). Regarding lipid profiles, findings revealed that ALA administration had no significant impact on HDL-C and TG levels among patients with CKD. However, compared to the control group, TC levels were considerably lower in CKD patients (WMD = -5.48 mg/dL, 95% CI: -10.55, -0.41, I² = 0.0%, P = 0.50). Moreover, the sensitivity analyses showed that pooled WMDs for LDL-C levels were significantly changed (-6.88 mg/dL, 95% CI, -12.78, -0.98).

Conclusions: These findings revealed that ALA supplementation slightly but significantly reduced blood levels of hs-CRP, TC, and LDL-C, but did not affect IL-6, MDA, HDL-C, weight, BMI, Fe, and Hb in patients with CKD.