{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:33:34Z","timestamp":1791909214334,"version":"4.3.4"},"reference-count":31,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T00:00:00Z","timestamp":1610928000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fundamental Research Grant Scheme (FRGS) - Ministry of Higher Education, Malaysia","award":["FRGS\/1\/2018\/SKK02\/MUSM\/02\/1"],"award-info":[{"award-number":["FRGS\/1\/2018\/SKK02\/MUSM\/02\/1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Diabetic kidney disease (DKD) is a debilitating complication of diabetes, which develops in 40% of the diabetic population and is responsible for up to 50% of end-stage renal disease (ESRD). Tocotrienols have shown to be a potent antioxidant, anti-inflammatory, and antifibrotic agent in animal and clinical studies. This study evaluated the effects of 400 mg tocotrienol-rich vitamin E supplementation daily on 59 DKD patients over a 12-month period. Patients with stage 3 chronic kidney disease (CKD) or positive urine microalbuminuria (urine to albumin creatinine ratio; UACR &gt; 20\u2013200 mg\/mmol) were recruited into a randomized, double-blind, placebo-controlled trial. Patients were randomized into either intervention group (n = 31) which received tocotrienol-rich vitamin E (Tocovid SupraBioTM; Hovid Berhad, Ipoh, Malaysia) 400 mg daily or a placebo group which received placebo capsules (n = 28) for 12 months. HbA1c, renal parameters (i.e., serum creatinine, eGFR, and UACR), and serum biomarkers were collected at intervals of two months. Tocovid supplementation significantly reduced serum creatinine levels (MD: \u22124.28 \u00b1 14.92 vs. 9.18 \u00b1 24.96), p = 0.029, and significantly improved eGFR (MD: 1.90 \u00b1 5.76 vs. \u22123.29 \u00b1 9.24), p = 0.011 after eight months. Subgroup analysis of 37 patients with stage 3 CKD demonstrated persistent renoprotective effects over 12 months; Tocovid improved eGFR (MD: 4.83 \u00b1 6.78 vs. \u22121.45 \u00b1 9.18), p = 0.022 and serum creatinine (MD: \u22127.85(20.75) vs. 0.84(26.03), p = 0.042) but not UACR. After six months post washout, there was no improvement in serum creatinine and eGFR. There were no significant changes in the serum biomarkers, TGF-\u03b21 and VEGF-A. Our findings verified the results from the pilot phase study where tocotrienol-rich vitamin E supplementation at two and three months improved kidney function as assessed by serum creatinine and eGFR but not UACR.<\/jats:p>","DOI":"10.3390\/nu13010258","type":"journal-article","created":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T03:34:25Z","timestamp":1611113665000},"page":"258","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["A Phase IIb Randomized Controlled Trial Investigating the Effects of Tocotrienol-Rich Vitamin E on Diabetic Kidney Disease"],"prefix":"10.3390","volume":"13","author":[{"given":"Yan Yi","family":"Koay","sequence":"first","affiliation":[{"name":"Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor 47500, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald Chen Jie","family":"Tan","sequence":"additional","affiliation":[{"name":"Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor 47500, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3969-8077","authenticated-orcid":false,"given":"Sonia Chew Wen","family":"Phang","sequence":"additional","affiliation":[{"name":"Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor 47500, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J-Ian","family":"Ho","sequence":"additional","affiliation":[{"name":"Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor 47500, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei Fen","family":"Chuar","sequence":"additional","affiliation":[{"name":"Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor 47500, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loon Shin","family":"Ho","sequence":"additional","affiliation":[{"name":"Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor 47500, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Badariah","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor 47500, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4206-0867","authenticated-orcid":false,"given":"Khalid","family":"Abdul Kadir","sequence":"additional","affiliation":[{"name":"Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor 47500, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"414","DOI":"10.2471\/BLT.17.206441","article-title":"The global burden of kidney disease and the sustainable development goals","volume":"96","author":"Luyckx","year":"2018","journal-title":"Bull. 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