scholarly journals Effects of valsartan combined with α-lipoic acid on renal function in patients with diabetic nephropathy: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fangfang Sun ◽  
Deqi Jiang ◽  
Juanjuan Cai
Keyword(s):  
Oxidative Stress ◽  
Renal Function ◽  
Diabetic Nephropathy ◽  
Lipoic Acid ◽  
Microvascular Complications ◽  
Urinary Albumin ◽  
Cochrane Library ◽  
Significant Difference ◽  
Hs Crp ◽  
And Oxidative Stress

Abstract Background Diabetic nephropathy (DN) is one of the most serious microvascular complications of diabetes, valsartan and α-lipoic acid alone or in combination has been used for the treatment of patients with DN. However, some results in these clinical reports were still controversial. The purpose of this study was to evaluate the efficacy of valsartan combined with α-lipoic acid on renal function in patients with DN. Methods We searched the electronic databases including PubMed, Sciencedirect, EMBASE, Cochrane library, Chinese national knowledge infrastructure (CNKI) and Wanfang databases, and the publication deadline was limited to January 2020. Randomized controlled trials (RCTs) evaluating the effects of valsartan combined with α-lipoic acid in DN patients were included. Pooled estimates were conducted using a fixed or random effect model. The outcomes included urinary albumin excretion rate (UAER), and the level of urinary albumin, β2-microglobulin (β2-MG), hypersensitive C-reactive protein (hs-CRP) and oxidative stress. Results 11 studies with 1294 participants were included in this study. The pooled analysis indicated that α-lipoic acid combined with valsartan could remarkably reduce UAER (P < 0.00001, SMD = -1.95, 95%CI = -2.55 to − 1.20; P = 0.03, SMD = -0.85, 95%CI = -1.59 to − 0.1) and the level of urinary albumin (P = 0.001, SMD = -1.48, 95%CI = − 2.38 to − 0.58; P = 0.01, SMD = -1.67, 95%CI = -3.00 to − 0.33), β2-MG (P < 0.001,SMD = − 2.59, 95%CI = -3.78 to − 1.40; P = 0.03, SMD = -0.48, 95%CI = -0.93 to − 0.04) when compared with valsartan or lipoic acid monotherapy in patients with DN. However, there was no significant difference in the level of hs-CRP among the three therapies (P = 0.06, SMD = -2.80, 95%CI = -5.67 to 0.07; P = 0.10, SMD = -0.42, 95%CI = − 0.92 to 0.08). In addition, α-lipoic acid combined with valsartan markedly increased the level of SOD (P = 0.03, SMD = 1.24, 95%CI = 0.32 to 1.03; P = 0.0002, SMD = 0.68, 95%CI = 0.32 to 1.03) and T-AOC (P < 0.00001, SMD = 0.89, 95%CI = 0.62 to 1.16; P = 0.02, SMD = 0.58, 95%CI = 0.10 to1.07), and reduced the level of MDA(P = 0.0002, SMD = -1.99, 95%CI = -3.02 to − 0.96; P = 0.0001, SMD = -0.69, 95%CI = -1.04 to − 0.34). Conclusions α-lipoic acid combined with valsartan could significantly reduce the level of urinary albumin and oxidative stress, increase antioxidant capacity and alleviate renal function damage in patients with DN, and this will provide a reference for the selection of treatment drugs for DN.

The effects of probiotic supplementation on renal function, inflammation, and oxidative stress in diabetic nephropathy: A systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 11 (7) ◽  
pp. 1122-1131
Author(s):  
Han Wang ◽  
Dunfang Wang ◽  
Hongxin Song ◽  
Dixin Zou ◽  
Xue Feng ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Renal Function ◽  
Diabetic Nephropathy ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Probiotic Supplementation ◽  
Randomized Controlled ◽  
And Oxidative Stress

Whether supplemental probiotic therapy improves clinical outcomes in diabetic nephropathy (DN) patients remains unclear. To uncover its impacts via meta-analysis, relevant randomized controlled trials (RCTs) were searched by means of PubMed, the Cochrane Library, Embase, and Web of Science as of August 31, 2020. The effect of probiotics was reported on renal function biomarkers, oxidative stress, inflammation, and serum albumin (ALB) levels among DN patients. Random- or fixed-effects models were used to estimate pooled standardized mean differences (SMDs). Seven RCTs (456 patients) were included for final analysis. The results showed that probiotic supplementation led to a significant increase in the estimated glomerular filtration rate (eGFR) (SMD: 6.03; 95% confidence interval [CI]: 0.84–11.21; P =0.020), glutathione (GSH) levels (P < 0.001), and total antioxidant capacity (TAC) (P < 0.001). In contrast, probiotic intake significantly decreased the serum creatinine (SCr) (P = 0.020), blood urea nitrogen (BUN) (P < 0.001), malondialdehyde (MDA) (P = 0.020), and high-sensitivity C-reactive protein (hs-CRP) (P < 0.001) contents. Serum Na, K, ALB, and nitric oxide (NO) concentrations showed no significant change. Probiotics are beneficial for DN patients through improving renal function and regulating the levels of inflammation and oxidative stress biomarkers. However, probiotics do not significantly affect serum ALB, NO, Na, and K levels. These results need to be confirmed through more reliable RCTs.

scholarly journals The Effects of Long-Term Chaetomellic Acid A Administration on Renal Function and Oxidative Stress in a Rat Model of Renal Mass Reduction

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
António Nogueira ◽  
Francisco Peixoto ◽  
Maria Manuel Oliveira ◽  
Carlos André Pires ◽  
Bruno Colaço ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Renal Function ◽  
Renal Mass ◽  
Wistar Rats ◽  
Reduced Glutathione ◽  
Mass Reduction ◽  
Significant Difference ◽  
Male Wistar Rats ◽  
And Oxidative Stress

Purpose.This study aimed to evaluate the effect of chronic treatment with chaetomellic acid A (CAA) on oxidative stress and renal function in a model of renal mass reduction.Methods. Male Wistar rats were subjected to 5/6 nephrectomy (RMR) or sham-operated (SO). One week after surgery, rats have been divided into four experimental groups: RMR: RMR rats without treatment(n=14); RMR + CAA: RMR rats treated with CAA(n=13); SO: SO rats without treatment(n=13); and SO + CAA: SO rats treated with CAA(n=13). CAA was intraperitoneally administered in a dose of 0.23 µg/Kg three times a week for six months.Results.RMR was accompanied by a significant reduction in catalase and glutathione reductase (GR) activity(p<0.05)and a decrease in reduced glutathione (GSH)/oxidized glutathione (GSSG) ratio. CAA administration significantly increased catalase and GR activity(p<0.05)and increased GSH/GSSG ratio, but no significant difference between the treated and nontreated groups was found in this ratio. No significant differences were found between the RMR groups in any of the parameters of renal function. However, CAA administration slightly improves some parameters of renal function.Conclusions.These data suggest that CAA could attenuate 5/6 RMR-induced oxidative stress.

scholarly journals Determining the Relationship Between Homocysteinemia and Biomarkers of Inflammation, Oxidative Stress and Functional Kidney Status in Patients with Diabetic Nephropathy

2013 ◽  
Vol 32 (2) ◽  
pp. 131-139 ◽  
Author(s):  
Velibor Čabarkapa ◽  
Mirjana Đerić ◽  
Zoran Stošić ◽  
Vladimir Sakač ◽  
Sofija Davidović ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Renal Function ◽  
Diabetic Nephropathy ◽  
Protein A ◽  
Macrovascular Complications ◽  
Control Group ◽  
Markers Of Oxidative Stress ◽  
Cystatine C ◽  
The Relationship ◽  
And Oxidative Stress

Summary Background: One of the leading causes of terminal renal failure is diabetic nephropathy. The aim of this study was to determine the relationship between homocysteine levels and the biomarkers of renal function, inflammation and oxidative stress, as well as the incidence of macrovascular complications in patients with diabetic nephropathy. Methods: Sixty-four patients with diabetic nephropathy were included in this study. They were divided according to their homocysteine levels into two groups: hyperhomocysteinemic (HHcy, n=47) and normohomocysteinemic patients (NHCy, n=17). The re sults were compared to a control group (n=20) with normal renal function and without diabetes. Besides homocysteine, cystatine C, creatinine, urea, albuminuria, creatinine clearance, lipid status parameters, apolipoprotein A-I and B, lipo protein (a), CRP, fibrinogen, oxidative LDL were determined using appropriate methods. The incidence of macro vascular diabetic complications was also determined. Results: The results indicate that the level of renal dysfunction is greater in HHcy than in NHcy patients (p<0.05). In HHcy patients levels of oxLDL were also higher compared to NHcy patients (119.3±140.4 vs. 71.4±50.8 ng/mL, disp< 0.05) as well as fibrinogen levels (4.3±1.3 vs. 3.7±0.8 g/L, p<0.05). The in cidence of macrovascular complications is more frequent in HHcy than in NHcy patients (55.3. vs. 35.3 %, p>0.05), and in patients with macroalbuminuria compared to patients with microalbuminuria (65% vs. 39%, p<0.05). Conclusions: It can be concluded that HHcy is significantly present in patients with diabetic nephropathy, especially if there is greater reduction of renal function. Besides that, significantly higher concentrations of inflammatory (fibrinogen) and oxidative stress (oxLDL) markers were present in HHcy patients with diabetic nephropathy compared to NHcy patients.Therefore in diabetic nephropathy patients it is useful to regularly monitor the levels of homocysteine, as well as inflammatory and markers of oxidative stress.

scholarly journals Inflammation and Oxidative Stress in Diabetic Nephropathy: New Insights on Its Inhibition as New Therapeutic Targets

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Akira Mima
Keyword(s):  
Oxidative Stress ◽  
Diabetic Nephropathy ◽  
Microvascular Complications ◽  
Great Promise ◽  
Diabetic Patients ◽  
Rodent Models ◽  
Negative Evidence ◽  
Normal Glucose ◽  
Anti Inflammatory ◽  
And Oxidative Stress

Diabetes and insulin resistance can greatly increase microvascular complications of diabetes including diabetic nephropathy (DN). Hyperglycemic control in diabetes is key to preventing the development and progression of DN. However, it is clinically very difficult to achieve normal glucose control in individual diabetic patients. Many factors are known to contribute to the development of DN. These include diet, age, lifestyle, or obesity. Further, inflammatory- or oxidative-stress-induced basis for DN has been gaining interest. Although anti-inflammatory or antioxidant drugs can show benefits in rodent models of DN, negative evidence from large clinical studies indicates that more effective anti-inflammatory and antioxidant drugs need to be studied to clear this question. In addition, our recent report showed that potential endogenous protective factors could decrease inflammation and oxidative stress, showing great promise for the treatment of DN.

scholarly journals The effects of selenium supplementation on biomarkers of inflammation and oxidative stress in patients with diabetic nephropathy: a randomised, double-blind, placebo-controlled trial

2016 ◽  
Vol 116 (7) ◽  
pp. 1222-1228 ◽  
Author(s):  
Fereshteh Bahmani ◽  
Mahsa Kia ◽  
Alireza Soleimani ◽  
Ali Akbar Mohammadi ◽  
Zatollah Asemi
Keyword(s):  
Oxidative Stress ◽  
Diabetic Nephropathy ◽  
Transforming Growth Factor ◽  
Controlled Trial ◽  
Matrix Metalloproteinase 2 ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Hs Crp ◽  
And Oxidative Stress

AbstractThis study was carried out to assess the effects of Se supplementation on biomarkers of inflammation and oxidative stress in patients with diabetic nephropathy (DN). This randomised, double-blind, placebo-controlled clinical trial was conducted among sixty patients with DN. Patients were randomly divided into two groups to take either 200 µg/d Se supplements as Se yeast (n 30) or placebo (n 30) for 12 weeks. In unadjusted analyses, compared with the placebo, Se supplementation led to a significant reduction in high-sensitivity C-reactive protein (hs-CRP) (−1069·2 (sd 1752·2) v. −135·3 (sd 1258·9) ng/ml, P=0·02), matrix metalloproteinase-2 (MMP-2) (−612·3 (sd 679·6) v. +76·0 (sd 309·1) ng/ml, P<0·001) and plasma malondialdehyde (MDA) concentrations (−0·1 (sd 0·7) v. +0·4 (sd 0·9) µmol/l, P=0·01). In addition, a significant increase in plasma total antioxidant capacity (TAC) (+174·9 (sd 203·9) v. +15·8 (sd 382·2) mmol/l, P=0·04) was observed following supplementation with Se compared with the placebo. Subjects who received Se supplements experienced a borderline statistically significant decrease in serum protein carbonyl (PCO) levels (P=0·06) compared with the placebo. When we adjusted the analysis for baseline values of biochemical parameters, age and BMI, serum hs-CRP (P=0·14) and MDA levels (P=0·16) became non-significant, whereas plasma nitric oxide (NO) (P=0·04) and glutathione (GSH) (P<0·001) became statistically significant, and other findings did not change. Supplementation with Se had no significant effect on NO, transforming growth factor β (TGF-β), advanced glycation end products (AGE), PCO and GSH compared with the placebo. Overall, our study demonstrated that Se supplementation among DN patients had favourable effects on serum MMP-2, plasma NO, TAC and GSH, but did not affect hs-CRP, TGF-β, AGE, PCO and MDA.

Carotenoids in Sporidiobolus pararoseus ameliorate diabetic nephropathy in mice through attenuating oxidative stress

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Chao Du ◽  
Tianqi Lv ◽  
Quanwen Liu ◽  
Yuliang Cheng ◽  
Chang Liu ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Renal Function ◽  
Diabetic Nephropathy ◽  
Fasting Blood Glucose ◽  
Urine Volume ◽  
Major Life ◽  
Urine Albumin ◽  
Oxidative Stress Status ◽  
Sporidiobolus Pararoseus ◽  
And Oxidative Stress

Abstract Diabetic nephropathy (DN) is the major life-threatening complication of diabetes, and oxidative stress takes part in its initiation and development. This study was performed to evaluate the effects of carotenoids from Sporidiobolus pararoseus (CSP) on the renal function and oxidative stress status of mice with streptozotocin (STZ)-induced DN. The results indicated that CSP significantly attenuated symptoms of STZ-induced DN shown by decreased fasting blood glucose, reduced urine volume, urine albumin, serum creatinine and serum urea nitrogen, and improved kidney histological morphology. Furthermore, biochemical analysis of serum and kidney revealed a marked increase in oxidative stress of DN mice as evidenced by reduced total antioxidant capacity (T-AOC), decreased activity of antioxidant enzyme -superoxide dismutase (SOD) and increased level of malondialdehyde (MDA). However, treatment with CSP improved oxidative stress status in DN mice as compared with the mice in model group. Exploration of the potential mechanism validated that CSP ameliorated the oxidative stress status in DN mice by activating the expressions of Nrf2, NQO-1, HO-1, GST and CAT in kidney. These data revealed that CSP may retard the progression of DN by ameliorating renal function, improving the oxidative stress status and activating the Nrf2/ARE pathway.

scholarly journals Lipoic acid effects on renal function, aminopeptidase activities and oxidative stress in Crotalus durissus terrificus envenomation in mice

Toxicon ◽  
2010 ◽  
Vol 56 (3) ◽  
pp. 402-410 ◽  
Author(s):  
Valter de Sousa Alegre ◽  
Juliana Marton Barone ◽  
Simone Cristina Yamasaki ◽  
Leonardo Zambotti-Villela ◽  
Paulo Flavio Silveira
Keyword(s):  
Oxidative Stress ◽  
Renal Function ◽  
Lipoic Acid ◽  
Crotalus Durissus Terrificus ◽  
Crotalus Durissus ◽  
And Oxidative Stress

Whey protein plus lipoic acid supplementation improves inflammatory and antioxidant markers of patients with acute ischemic stroke

2020 ◽  
Vol 50 (6) ◽  
pp. 1053-1062 ◽  
Author(s):  
Yalda Sadeghpour ◽  
Aliakbar Taheraghdam ◽  
Mohammad Khalili ◽  
Mazyar Hashemilar ◽  
Elyar Sadeghi Hokmabadi ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Whey Protein ◽  
Lipoic Acid ◽  
Intervention Group ◽  
Control Group ◽  
Content Type ◽  
Acid Supplementation ◽  
Stress Markers ◽  
Hs Crp ◽  
And Oxidative Stress

Purpose Although the pathogenesis of stroke is not yet completely elucidated, factors such as oxidative stress and inflammation have been shown to play an important role in this regard. The purpose of this paper is to investigate the effects of whey protein plus lipoic acid on the inflammatory and oxidative stress markers and the prognosis in acute ischemic stroke (AIS) patients. Design/methodology/approach A double-blind, randomized controlled clinical trial was conducted among 42 patients with the first episode of AIS at the Imam Reza Hospital of the Tabriz University of Medical Sciences. The blind research staff randomly assigned patients to two groups of receiving usual hospital gavage (control group) and 1,200 mg of lipoic acid plus 20 g of whey protein in addition to usual hospital gavage (intervention group) for midday meal. Levels of albumin, Interleukin-6 (IL-6), tumor necrosis factor (TNF-α), high-sensitivity C-reactive protein (hs-CRP) and clinical outcomes including severity of neurologic damage according to National Institutes of Health Stroke Scale (NIHSS) and functional state based on modified Rankin Scale (mRS) were evaluated initially and three weeks later. Findings There were no significant differences in demographic and baseline characteristics between the two groups (p > 0.05). After three weeks, hs-CRP (p <* 0.01), IL-6 (p = 0.02) and TNF-α (p = 0.01) levels significantly reduced in the intervention group, but no significant changes were observed in cases of albumin, malondialdehyde (MDA) and total antioxidant capacity (TAC) in this group (p > 0.05). Instead, only IL-6 decreased significantly in the control group (p <* 0.01). In addition, comparing changes of assessed variables between two groups showed no significant improvement in the whey protein plus lipoic acid supplementation group vs the control group (p > 0.05). While there was significant betterment in clinical prognosis parameters within groups, no significant changes were found between groups. Originality/value The investigation implied that whey protein plus lipoic acid supplementation has no significant effects on inflammatory and oxidative stress markers compared to the control group of AIS patients. More studies in this field are needed to approve the result.

scholarly journals Effects of Vitamin D Supplementation on Renal Function, Inflammation and Glycemic Control in Patients with Diabetic Nephropathy: a Systematic Review and Meta-Analysis

2019 ◽  
Vol 44 (1) ◽  
pp. 72-87 ◽  
Author(s):  
Yangyang  Wang ◽  
Shikun  Yang ◽  
Qianying  Zhou ◽  
Hao  Zhang ◽  
Bin  Yi
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Renal Function ◽  
Diabetic Nephropathy ◽  
Glycemic Control ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Urine Protein ◽  
Hs Crp ◽  
The Impact

Background/Aims: Vitamin D (VD) is widely recognized as renal protective. However, whether VD supplementation provides benefit to patients with diabetic nephropathy (DN) remains controversial. Here, we performed a meta-analysis to systematically evaluate the impact of VD supplementation on indexes of renal function, inflammation and glycemic control in DN patients, and to explore the potential renal protective mechanism of VD. Methods: We searched Pubmed, Embase, Cochrane Library, and three major Chinese biomedical databases (CNKI, WANGFANG and VIP) for randomized controlled trials (RCTs) examining the effects of VD or its analogs in DN patients, published between September 2007 and July 2018. Quality assessment and data extraction were performed independently by two authors, according to the Cochrane systematic review methods. Meta-analysis based on the extracted results were performed via Revman 5.2 software. Results: We included 20 RCTs representing 1,464 patients with DN in this meta-analysis. VD supplementation significantly reduced 24-hour urine protein [MD = -0.26; 95% CI (-0.34, -0.17); P < 0.00001; I2 = 95%], UAER [MD = -67.36; 95% CI (-91.96, -42.76); P < 0.00001; I2 = 97%], hs-CRP [MD = -0.69; 95% CI (-0.86,-0.53); P < 0.00001; I2 = 0%], TNF-α [MD = -56.79; 95% CI (-77.05, -36.52); P < 0.00001; I2 = 89%] and IL-6 [MD = -0.73; 95% CI(-1.03, -0.44); P < 0.00001; I2 = 0%]. However, VD supplementation failed to decrease SCr [MD = -0.83; 95% CI (-3.67,2.02); P = 0.57; I2 = 0%] or increase eGFR [MD = 2.13; 95% CI (-2.06, 6.32); P = 0.32; I2 = 0%]. In addition, VD supplementation showed no impact on indexes of glycemic control, such as HbA1c [MD = 0.01; 95% CI (-0.09, 0.11); P = 0.84; I2 = 0%] and FBG [MD = -0.05; 95% CI (-0.29, 0.20); P = 0.70; I2 = 0%]. Analysis of 24-hour urine protein, SCr, eGFR, hs-CRP or HbA1c revealed no difference between subgroups based on the type of VD supplementation, including calcitriol, alfacalcidol and vitamin D3, and the dose or duration of calcitriol usage. Conclusion: In patients with DN, VD supplementation provides beneficial effects on 24-hour urine protein and inflammation indexes, but not on SCr, eGFR or glycemic control indexes. More RCTs that comprehensively evaluate the impact of VD supplementation on indexes of renal function, inflammation and glycemic control in DN atients are required in order to reach conclusive results.

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