People living with chronic kidney disease (CKD) often suffer from high levels of inflammation and oxidative stress, which can damage cells and accelerate disease progression. Recently, two supplements—Nicotinamide Riboside (NR) and Coenzyme Q10 (CoQ10)—have drawn attention for their potential to support kidney health. This post explores what these supplements are, what the research says, and whether they are safe and effective for people with CKD.
Nicotinamide Riboside (NR)
A form of vitamin B3
Helps increase NAD⁺, a molecule crucial for energy production and cell repair
Studied for anti-aging, brain support, and metabolism improvement
Coenzyme Q10 (CoQ10)
A compound naturally found in mitochondria
Supports energy production and works as a powerful antioxidant
Widely used for heart health and fatigue reduction
A 2025 clinical trial published in CJASN studied 25 people with CKD for 6 weeks:
| Group | Supplement | Results |
|---|---|---|
| Placebo | None | No significant change |
| NR (1000 mg/day) | Boosted mitochondrial function, lowered oxidative stress | |
| CoQ10 (1200 mg/day) | Reduced inflammation, improved lipid metabolism |
The NR group showed the strongest effect in improving cellular energy and reducing specific oxidative stress markers. Both supplements helped reduce overall oxidative stress.
| Supplement | Usual Dose | Benefits | CKD Suitability |
|---|---|---|---|
| NR | 250–300 mg/day | Energy metabolism, anti-aging | Use under medical guidance |
| CoQ10 | 100–300 mg/day | Antioxidant, heart protection | Generally considered safe |
CoQ10 is commonly used and well tolerated, including in people with cardiovascular disease. NR is promising but lacks long-term safety data, especially in advanced kidney disease (eGFR < 30). Always consult a healthcare provider before starting NR.
Mr. Kim, age 56, was recently diagnosed with stage 3 CKD after many years of hypertension and diabetes. He reported frequent fatigue and elevated markers of oxidative stress. After starting CoQ10 (200 mg/day) with meals, he noticed reduced fatigue after 3 months. He later added low-dose NR (250 mg/day) under his doctor’s supervision.
NR
Dose: 250–300 mg/day
Can be taken on an empty stomach or with food
Best for fatigue, metabolism, and NAD⁺ support
CoQ10
Dose: 100–300 mg/day
Should be taken after meals (fat-soluble)
Helpful for energy, antioxidant protection, and cardiovascular support
| Supplement | Possible Concerns |
|---|---|
| NR | May cause mild nausea or elevate liver enzymes at high doses |
| CoQ10 | May interact with warfarin; mild digestive issues in rare cases |
(Insert your infographic image here to visually show the results of the study, such as changes in oxidative stress markers.)
Ahmadi A, Valencia AP, Begue G, et al. A Pilot Trial of Nicotinamide Riboside and Coenzyme Q10 on Inflammation and Oxidative Stress in CKD. CJASN. 2025;20:346–357. doi:10.2215/CJN.0000000624
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