Effects of Alpha-Lipoic Acid Supplementation on Weight Loss, Inflammatory, Lipid, and Hematological Levels in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The effects of alpha-lipoic acid (ALA) supplementation on cardiovascular-related factors have been evaluated in a number of randomized clinical trials, 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. 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 2 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. Nine of the 421 potential reports were included. Using random-effects models, no significant changes were observed in weight loss, body mass index, hemoglobin, and iron following ALA supplementation (600 mg/day). Results exhibited that ALA significantly reduced high-sensitivity C-reactive protein levels in individuals with CKD (weighted mean difference (WMD) = −2.91 mg/L, 95% CI: −4.65, −1.17, I2 = 50.5%, P = .09); however, there were no significant variations in levels of interleukin-6 (IL-6) or malondialdehyde. Regarding lipid profiles, findings revealed that ALA administration had no significant impact on high-density lipoprotein cholesterol and triglycerides levels among patients with CKD. However, compared to the control group, total cholestrol levels were considerably lower in CKD patients (WMD = −5.48 mg/dL, 95% CI: −10.55, −0.41, I2 = 0.0%, P = .50). Moreover, the sensitivity analyses showed that pooled WMDs for low-density lipoprotein cholesterol levels were significantly changed (−6.88 mg/dL, 95% CI, −12.78, −0.98). These findings revealed that ALA supplementation slightly but significantly reduced blood levels of high-sensitivity C-reactive protein, total cholestrol, and low-density lipoprotein cholesterol, but did not affect IL-6, malondialdehyde, high-density lipoprotein cholesterol, weight, body mass index, iron, and hemoglobin in patients with CKD.