CKD NUTRITION, INFLAMMATION AND OXIDATIVE STRESS

Abstract

Introduction and Aims: Increased consumption of added sugars and high-fructose corn syrup in diet is known risk factor for cardiovascular diseases and metabolic disorders. High fructose diet contributes to uric acid (UA) generation that is a crucial link to initiate an oxidative stress, inflammation and organ damage. The aim of the study was assessment of lipid disorders, inflammatory state markers, changes in blood preassure, organ damage indices and UA changes during fructose tolerance test (FTT) in chronic kidney disease (CKD ) patients stage 3, metabolic syndrome patients (according to ATP III criteria) in compare to control group. Methods: 36 patients-BMI>30 and metabolic syndrome, 14 patients-CKD stage 3. Control group-25 healthy volunteers. FTT-oral intake of fructose in dose 1g/kg/body weight and blood assessment of UA at 0, 30, 60, 120 minute of test was performed in each patient. Morning blood samples were taken for: creatinine, uric acid, sodium, glucose, insulin, triglycerides, HDL and LDL cholesterol, calcium, phosphorus, hsCRP , MCP-1, EPO, TNF-α, TGF-β, iNOS, eNOS. 24-hr urine collection for: sodium, calcium, phosphorus, creatinine, uric acid, NAG, albumin was performed. The day before urine collection and blood sampling ABPM, BMI, waist circumference, IMT (intima media thickness, renal doppler ultrasound (RI, PI, AccT) were done. Results: There were no statistically signifficant differencies in ΔUAvalues in 0,30,60,120 minute of FTT in analyzed groups. The absolute increase in UA was highest in CKD, obesity group in compare to control. There were no statistically significant relationship between ΔUA at 60minute of FTT and blood pressure, CRP, glucose, total cholesterol, albuminuria, BMI, waist circumference, iNOS, eNOS, MCP-1, TGF-β, TNF-α in investigated groups. There were statistically significant positive relationship between ΔUA at 60minute of FTT and RI( resistance index): (r-0,34; p-0,052); PI( pulsatility index):(r-0,34;p-0,051) in patients with BMI>30 and metabolic syndrome. (Table 1). Conclusions: An increase in UA related with fructose load may influence increase in intrarenal resistance independently of eGFR changes. (Table presented).