Oral supplementation of turmeric attenuates proteinuria, transforming growth factor-ß and interleukin-8 levels in patients with overt type 2 diabetic nephropathy: a randomized, double-blind and placebo-controlled study.

OBJECTIVE: End-stage renal disease (ESRD) due to type 2 diabetic nephropathy is a very common condition which is increasing in prevalence, and is associated with high global levels of mortality and morbidity. Both proteinuria and transforming growth factor-ß (TGF-ß) may contribute to the development of ESRD in patients with diabetic nephropathy. Experimental studies indicate that turmeric improves diabetic nephropathy by suppressing TGF-ß. Therefore, this study investigated the effects of turmeric on serum and urinary TGF-ß, interleukin-8 (IL-8) and tumour necrosis factor-α (TNF-α), as well as proteinuria, in patients with overt type 2 diabetic nephropathy. MATERIAL AND METHODS: A randomized, double-blind and placebo-controlled study was carried out in the Diabetes Clinic of the Outpatient Department of Shiraz University of Medical Sciences on 40 patients with overt type 2 diabetic nephropathy, randomized into a trial group (n = 20) and a control group (n = 20). Each patient in the trial group received one capsule with each meal containing 500 mg turmeric, of which 22.1 mg was the active ingredient curcumin (three capsules daily) for 2 months. The control group received three capsules identical in colour and size containing starch for the same 2 months. RESULTS: Serum levels of TGF-ß and IL-8 and urinary protein excretion and IL-8 decreased significantly comparing the pre- and post-turmeric supplementation values. No adverse effects related to turmeric supplementation were observed during the trial. CONCLUSION: Short-term turmeric supplementation can attenuate proteinuria, TGF-ß and IL-8 in patients with overt type 2 diabetic nephropathy and can be administered as a safe adjuvant therapy for these patients.

Relation of serum albumin and C-reactive protein to hypotensive episodes during hemodialysis sessions.

To evaluate the effect of albumin serum levels and C-reactive protein (CRP) on the course of dialysis induced hypotension (DIH) in chronic hemodialysis (HD) patients, we studied 58 chronic hemodialysis patients in our center during 2007. We investigated the correlation between serum albumin, highly sensitive CRP (hs-CRP) and DIH. The mean of the serum albumin levels was 4.2 +/- 0.5 g/dL, and 32.8% of the patients revealed hypoalbuminemia. Occurrence of DIH among HD patients was 27.6%. The mean of serum albumin levels in the DIH group was significantly lower compared with the normotensive group (3.9 +/- 0.4 vs 4.3 +/- 0.5 g/dL, respectively, P= 0.008). The mean of the hs-CRP levels was significantly higher in the DIH group compared with the normotensive group (12.9 +/- 12 vs. 7.2 +/- 5.2 mg/dL, respectively, P= 0.01). We conclude that high level of CRP and hypoalbuminemia may be predictors of DIH.

A comparison of sodium bicarbonate infusion versus normal saline infusion and its combination with oral acetazolamide for prevention of contrast-induced nephropathy: a randomized, double-blind trial.

BACKGROUND: Contrast-induced nephropathy (CIN) is commonly encountered. Because the therapy of choice for prevention of CIN is controversial, in this study we compared the preventive efficacy of bicarbonate (Bi) infusion in dextrose water versus normal saline (NLS) infusion alone or in combination with oral acetazolamide (AZ). METHODS: In a double-blind and randomized clinical trial, all patients undergoing coronary angiography or percutaneous coronary intervention received NLS (NLS group), its combination with AZ (AZ group) or infusion of Bi (Bi group) before the procedures. RIFLE (risk of renal failure, injury to the kidney, failure of kidney function, loss of kidney function, and end-stage renal disease) criteria were used to define CIN-associated acute kidney injury (AKI). RESULTS: The risk of AKI in CIN was significantly lower in the Bi and AZ groups than in the NLS group (P 0.05). CONCLUSIONS: It seems that both Bi and AZ reduce the risk of CIN-related AKI, and close monitoring of serum potassium is needed during bicarbonate infusion.