The Role of Dietary Antioxidants on Oxidative Stress in Diabetic Nephropathy.

Diabetic nephropathy (ND) is the leading cause of end-stage renal disease and oxidative stress (OS) has been recognized as a key factor in the pathogenesis and progression. Hyperglycemia, reactive oxygen species, advanced glycation end products, arterial pressure, insulin resistance, decrease in nitric oxide, inflammatory markers, and cytokines, among others; are involved in the presence of OS on ND. This revision focus on diverse studies in experimental and human models with diabetes and DN that has been demonstrated beneficial effects of different dietary antioxidant as resveratrol, curcumin, selenium, soy, catechins, α-lipoic acid, coenzyme Q10, omega-3 fatty acids, zinc, vitamins E and C, on OS and the capacity for antioxidant response. Therefore, this interventions could have a positive clinical impact on DN.

Asociación de albúmina sérica y valoración global subjetiva en pacientes incidentes en diálisis peritoneal / Association of serum albumin and subjective global assessment on incident peritoneal dialysis patients

Introducción: la albúmina sérica es el biomarcador más frecuentemente utilizado como uno de los tres criterios bioquímicos para el diagnóstico del desgaste proteico energético (DPE). Sin embargo, como parámetro nutricional es poco fiable en la enfermedad renal crónica (ERC). La valoración global subjetiva (VGS) ha sido recomendada para la evaluación nutricional y del DPE en ERC. Objetivo: determinar la asociación de los niveles de albúmina sérica y la VGS en pacientes con insuficiencia renal crónica terminal (IRCT) que iniciaron diálisis peritoneal (DP). Métodos: estudio transversal analítico en pacientes con IRCT que fueron evaluados previo a iniciar DP. Se determinaron niveles de albúmina sérica y se realizó una evaluación nutricional mediante la VGS. Resultados: 69 pacientes, 46 (67%) hombres y 23 (33%) mujeres, con una media de edad de 39,97±18,30 años, albúmina sérica 2,75±0,65 g/dl, creatinina 18,91±10,98 mg/dl, urea 314,80±152,74 mg/dl e IMC 23,37±3,79 kg/m2, la mediana de TFG 3 (1-12) mL/min/1,73m2. La VGS mostró que el 34,8% estaba bien nutrido, el 40,6% tenía riesgo de DPE o moderado y el 24,6% presentaba un DPE severo. No existió asociación (p=ns) entre los niveles de albúmina sérica y la VGS. Conclusión: el presente estudio muestra que la hipoalbuminemia y el DPE son muy frecuentes. La identificación de los niveles de albúmina sérica y la VGS al iniciar DP en nuestra población pudieran ser predictores de mortalidad. La albúmina sérica no es una herramienta útil para la evaluación nutricional en pacientes con IRCT que iniciarán DP (AU)

Introduction: serum albumin the biomarker most frequently used as one of three biochemical criteria for diagnosis of protein energy wasting (PEW). However, as a nutritional parameter it’s unreliable in chronic kidney disease (CKD). The subjective global assessment (SGA) has been recommended for nutritional evaluation and the PEW in CKD. Objective: determine association between the levels of serum albumin and SGA in patients with end stage renal disease (ESRD) who started peritoneal dialysis (PD). Methods: a cross-sectional study in patients with ESRD were evaluated prior to starting PD. Levels of serum albumin were determined and nutritional assessment was performed by SGA. Results: 69 patients, 46 (67%) men and 23 (33%) women, average age 39.97±18.30 years old, serum albumin 2.75±0.65 g/dl, creatinine 18.91±10.98 mg/dl, urea 314.80±152.74 mg/dl and BMI 23.37±3.79 kg/m2 , median of GFR 3 (1-12) mL/min/1.73m2 . The SGA showed that 34.8% was well nourished, 40.6% had risk of moderate PEW and the 24.6% had severe PEW. There was no association (p=ns) between the levels of serum albumin and SGA. Conclusion: the present study shows hypoalbuminemia and PEW are very frequent. The identification of levels of serum albumin and SGA at the beginning of PD in our population could be predictors of mortality. Serum albumin is not a useful tool for nutritional assessment in patients with ERSD who initiate PD (AU)