MV-ONE PLUS is an antioxidant nutraceutical especially designed for people with CKD. It is specifically formulated to provide adjuvant support to help achieve good clinical outcomes. A concentrated formulation for greater convenience. High levels of vitamin D (4000IU of Vitamin D3). Dual purpose: vitamin supplementation and antioxidant activity. Vitamin D (25-hydroxyvitamin D, 25(OH)2D) deficiency, or hypovitaminosis D, is highly prevalent in patients with CKD and is potentially involved in complications in the hemodialysis population.

ESA resistance occurs relatively often in patients with CKD, and it is associated with suboptimal clinical outcomes. Vitamin D deficiency, as well as factors such as inflammation, could be involved in ESA resistance (Mucsi et al. 2010). Other studies have reported similar findings (Icardi et al. 2013).

Bucharles et al. (2012) reported the beneficial impact of cholecalciferol supplementation on biomarkers of mineral metabolism, inflammation, and cardiac function in a group of patients who were on hemodialysis and presented with hypovitaminosis D and low intact parathyroid hormone. Additional studies have suggested that vitamin D3 ameliorates proteinuria (Paul et al. 2013). Studies evaluating the long-term use of cholecalciferol have reported no adverse effects (Delanaye et al. 2013).

Gamma-tocopherol, the major form of vitamin E, has been reported to inhibit the cyclooxygenase (COX)-2-catalyzed formation of prostaglandin E2. Gamma-tocopherol could have anti-inflammatory properties similar to those found in nonsteroidal anti-inflammatory drugs. By contrast, alpha-tocopherol, the predominant form of vitamin E in the tissues and in most supplements, has been reported to be less effective than gamma-tocopherol and its major metabolite in inhibiting COX activity in macrophages and epithelial cells (Jiang et al. 2000).

Only a few vitamin E intervention studies with clinical endpoints have been reported in patients with ESRD. Early studies reported the protective effect of vitamin E and the slowing of atherosclerosis progression in patients on hemodialysis (Mune et al. 1999).

One of the first studies was the SPACE (Secondary Prevention with Antioxidants of Cardiovascular Disease in Endstage Renal Disease) trial, which reported a reduction in cardiovascular disease endpoints and myocardial infarction using high-dose vitamin E supplementation (800 IU/day). However, despite the reduction in cardiovascular disease endpoints, no significant reduction in mortality was observed (Boaz et al. 2000).

Himmelfarb et al. (2003) examined the major components of vitamin E in both healthy subjects and patients on hemodialysis and reported that administering gamma-tocopherol in the form of 300 to 600 mg/day of vitamin E to patients on maintenance hemodialysis significantly reduced median serum C-reactive protein.

It has been documented that endothelial dysfunction due to reduced nitric oxide (NO) availability precedes the development of atherosclerosis. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO synthase, is not only a cause of endothelial dysfunction, it is also a predictor of cardiovascular outcome in patients who have ESRD and are on hemodialysis.

Alpha-lipoic acid (ALA), a strong antioxidant, is both fat and water soluble. It increases NO-mediated vasodilation in patients with diabetes. Chang et al. (2007) found that administering ALA (600 mg/day) for 12 weeks resulted in a significant reduction in the plasma level of ADMA without specific side effects in patients who had diabetes and ESRD and were on maintenance hemodialysis. These findings have been replicated using the same ALA dose regimen in hemodialysis patients (Khabbazi et al. 2012). More recently, ALA has been reported to attenuate lipopolysaccharide-induced kidney injury in animal models by the suppression of apoptosis, inflammation, and renal tubular dysfunction (Suh et al. 2013).