Hemodiyaliz hastalarında diyetin antioksidan kapasitesi ile serum oksidatif stres indeksi arasındaki ilişki

Year 2023, Volume: 48 Issue: 1, 72 - 83, 31.03.2023

Hacer Alataş , Mendane Saka , Nurgül Arslan , Bülent Yaprak , Önder Otlu , İrem Pembegül

https://doi.org/10.17826/cumj.1179523

Abstract

Amaç: Oksidatif stres böbrek yetmezliği gibi üremik durumlarda ve hemodiyaliz sırasında artar. Bu çalışmada hemodiyaliz hastalarında diyetin toplam antioksidan kapasitesi ile serum oksidatif stres (sOSI) indeksi arasındaki ilişkinin incelenmesi amaçlanmıştır.
Gereç ve Yöntem: Bu çalışmaya 82 birey (41 hasta ve 41 kontrol) dahil edilmiştir. Bireylerin demografik özellikleri ve antropometrik ölçümleri araştırmacılar tarafından alınmıştır. Beslenme durumlarını belirlemek için 3 günlük besin tüketim kayıtları alınmış ve diyetin toplam antioksidan kapasitesi hesaplanmıştır.
Bulgular: Çalışmaya katılan bireylerin yaş ortalaması 54,01±2,24 yıl olarak bulundu. Hemodiyaliz tedavisi süresi ortalama 4,8±3,12 yıldır. Hemodiyaliz hastalarının %41,46'sı orta derecede malnütrisyonluydu. Diyet oksijen radikal soğurma kapasitesi (dORAC) (μmol) ölçüm sonucu hemodiyaliz ve kontrol gruplarında sırasıyla 2415,3±1073,45, 5468,4±2393,85 olarak bulundu. Yapılan çoklu lojistik regresyon analizinde hemodiyaliz hastalarında beden kütle indeksi (OR 2.21 %95 CI 1.050-2.317) ve triseps deri kıvrım kalınlığı değerlerindeki (OR 3.22 %95 CI 1.722-4.001) azalma sOSI değerinde artışa neden olmuştur. Hemodiyaliz hastalarında diyetle alınan protein (OR 1.23 95% CI 1.003-3.189), C vitamini (OR 2.88 95% CI 1.004-3.106) ve dTAC (OR 2.04 95% CI 1.967-2.001) arttığında sOSI değeri düşmektedir.
Sonuç: Diyet total antioksidan kapasitesi ile serum antioksidan düzeyi arasında pozitif bir ilişki vardır ve hemodiyaliz hastalarının diyet antioksidan kapasitesinin sağlıklı bireylere göre anlamlı derecede düşük olduğu belirlenmiştir. Çalışma sonuçlarına göre diyet antioksidan kapasitesinin artırılması için hemodiyaliz hastalarının besin tüketim durumlarının takibi önerilmektedir

Keywords

Kronik böbrek yetmezliği, hemodiyaliz, diyet total antioksidan kapasitesi, serum oksidatif stres indeksi

The relationship between dietary antioxidant capacity and serum oxidative stress index of hemodialysis patients

Abstract

Purpose: Oxidative stress increases in uremic conditions such as kidney failure and during hemodialysis. In this study, it was aimed to examine the relationship between the total antioxidant capacity of the diet and the serum oxidative stress (sOSI) index in hemodialysis patients.
Materials and Methods: In this study conducted with 82 individuals (41 patients and 41 controls). Demographic characteristics and anthropometric measurements of the individuals were taken by researchers. In order to determine the nutritional status of the individuals, 3-day food consumption records were taken and the total antioxidant capacity of the diet was calculated.
Results: The mean age of the individuals participating in the study was found to be 54.01±2.24 years. Hemodialysis treatment mean for 4.8±3.12 years. While 41.46% of hemodialysis patients were moderately malnourished. Dietary Oxygen Radical Absorption Capacity (dORAC) (μmol) measurement result was found to be 2415.3±1073.45, 5468.4±2393.85 in the hemodialysis and control groups, respectively. In the multiple logistic regression analysis performed, the decrease in body mass index (OR 2.21 95% CI 1.050-2.317) and triceps skinfold thickness values (OR 3.22 95% CI 1.722-4.001) in hemodialysis patients led to an increase in the sOSI value. It has been observed that when dietary protein (OR 1.23 95% CI 1.003-3.189), vitamin C (OR 2.88 95% CI 1.004-3.106) and dTAC (OR 2.04 95% CI 1.967-2.001) increase, the sOSI value decreases in hemodialysis patients.
Conclusion: There is a positive relationship between diet total antioxidant capacity and serum antioxidant level, and it was determined that the dietary antioxidant capacity of hemodialysis patients was significantly lower than that of healthy individuals. According to the results of the study, it is recommended to monitor the food consumption status of hemodialysis patients in order to increase the dietary antioxidant capacity.

Keywords

Chronic renal failure, hemodialysis, diet total antioxidant capacity, serum oxidative stress ındex

References

• 1. Levey AS, Coresh J. Chronic kidney disease. The lancet. 2012;379(9811):165-80.
• 2. Birben E, Sahiner UM, Sackesen C, Erzurum S, Kalayci OJWaoj. Oxidative stress and antioxidant defense. 2012;5(1):9-19.
• 3. Kalantar-Zadeh K, Ikizler TA, Block G, Avram MM, Kopple JDJAjokd. Malnutrition-inflammation complex syndrome in dialysis patients: causes and consequences. 2003;42(5):864-81.
• 4. Stepniewska J, Gołembiewska E, Dołegowska BJCPPS. Doma nski, M.; Ciechanowski, K. Oxidative stress and antioxidative enzyme activities in chronic kidney disease and different types of renal replacement therapy. 2015;16:243-8.
• 5. Krofič Žel M, Tozon N, Nemec Svete AJJovim. Plasma and erythrocyte glutathione peroxidase activity, serum selenium concentration, and plasma total antioxidant capacity in cats with IRIS stages I–IV chronic kidney disease. 2014;28(1):130-6.
• 6. Stępniewska J, Dołęgowska B, Popińska M, Sałata D, Budkowska M, Gołembiewska E, et al. Prooxidative-antioxidative balance of cells in different types of renal replacement therapy. 2014;37(1):4-11.
• 7. Locatelli F, Canaud B, Eckardt KU, Stenvinkel P, Wanner C, Zoccali CJNDT. Oxidative stress in end‐stage renal disease: an emerging threat to patient outcome. 2003;18(7):1272-80.
• 8. Sahni N, Gupta K, Rana S, Prasad R, Bhalla AJJoRN. Intake of antioxidants and their status in chronic kidney disease patients. 2012;22(4):389-99.
• 9. Wang Y, Yang M, Lee S-G, Davis CG, Koo SI, Chun OKJJotAoN, et al. Dietary total antioxidant capacity is associated with diet and plasma antioxidant status in healthy young adults. 2012;112(10):1626-35.
• 10. Wang Y, Yang M, Lee S-G, Davis CG, Kenny A, Koo SI, et al. Plasma total antioxidant capacity is associated with dietary intake and plasma level of antioxidants in postmenopausal women. 2012;23(12):1725-31.
• 11. Narmaki E, Siassi F, Koohdani F, Qorbani M, Shiraseb F, Ataie-Jafari A, et al. Dietary diversity as a proxy measure of blood antioxidant status in women. 2015;31(5):722-6.
• 12. Lim JU, Lee JH, Kim JS, Hwang YI, Kim T-H, Lim SY, et al. Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients. 2017;12:2465.
• 13. Scott BJ. 39 Frame Size, Circumferences, and Skinfolds. 2010.
• 14. Haytowitz DB, Bhagwat SJUDoA. USDA database for the oxygen radical absorbance capacity (ORAC) of selected foods, Release 2. 2010;3(1):10-48.
• 15. Carlsen MH, Halvorsen BL, Holte K, Bøhn SK, Dragland S, Sampson L, et al. The total antioxidant content of more than 3100 foods, beverages, spices, herbs and supplements used worldwide. 2010;9(1):1-11.
• 16. Dehne LI, Klemm C, Henseler G, Hermann-Kunz EJEjoe. The German food code and nutrient data base (BLS II. 2). 1999;15(4):355-8.
• 17. Harma M, Harma M, Kocyigit A, Erel OJMRGT, Mutagenesis E. Increased DNA damage in patients with complete hydatidiform mole. 2005;583(1):49-54.
• 18. Chao C-T, Chiang C-KJJoRN. Uremic toxins, oxidative stress, and renal fibrosis: an interwined complex. 2015;25(2):155-9.
• 19. Gupta RK, Patel AK, Shah N, Choudhary AK, Jha UK, Yadav UC, et al. Oxidative stress and antioxidants in disease and cancer: a review. 2014;15(11):4405-9.
• 20. Russa DL, Pellegrino D, Montesanto A, Gigliotti P, Perri A, Russa AL, et al. Oxidative balance and inflammation in hemodialysis patients: biomarkers of cardiovascular risk? 2019;2019.
• 21. Ebert T, Neytchev O, Witasp A, Kublickiene K, Stenvinkel P, Shiels PGJA, et al. Inflammation and oxidative stress in chronic kidney disease and dialysis patients. 2021;35(17):1426-48.
• 22. Vashistha T, Mehrotra R, Park J, Streja E, Dukkipati R, Nissenson AR, et al. Effect of age and dialysis vintage on obesity paradox in long-term hemodialysis patients. 2014;63(4):612-22.
• 23. White SL, Chadban SJ, Jan S, Chapman JR, Cass AJBotWHO. How can we achieve global equity in provision of renal replacement therapy? 2008;86:229-37.
• 24. Rambod M, Bross R, Zitterkoph J, Benner D, Pithia J, Colman S, et al. Association of Malnutrition-Inflammation Score with quality of life and mortality in hemodialysis patients: a 5-year prospective cohort study. 2009;53(2):298-309.
• 25. Turin TC, Tonelli M, Manns BJ, Ravani P, Ahmed SB, Hemmelgarn BRJNDT. Chronic kidney disease and life expectancy. 2012;27(8):3182-6.
• 26. Aydin Z, Uzun S, Karadag S, Gursu M, Doner B, Sevim Y, et al. Anthropometric measurements in hemodialysis patients. 2015.
• 27. Kalantar-Zadeh K, Abbott KC, Salahudeen AK, Kilpatrick RD, Horwich TBJTAjocn. Survival advantages of obesity in dialysis patients. 2005;81(3):543-54. 28. Griffin KA, Kramer H, Bidani AKJAJoP-RP. Adverse renal consequences of obesity. 2008.
• 29. Kazory A, Klein A, Chalopin J-M, Ducloux D, Courivaud CJNDT. Obesity and atherosclerotic events in chronic hemodialysis patients: a prospective study. 2013;28(suppl_4):iv188-iv94.
• 30. Kramer HJ, Saranathan A, Luke A, Durazo-Arvizu RA, Guichan C, Hou S, et al. Increasing body mass index and obesity in the incident ESRD population. 2006;17(5):1453-9.
• 31. Bossola M, Tazza L, Giungi S, Luciani GJKi. Anorexia in hemodialysis patients: an update. 2006;70(3):417-22.
• 32. Bossola M, Tazza L, Luciani GJJoRN. Mechanisms and treatment of anorexia in end-stage renal disease patients on hemodialysis. 2009;19(1):2-9.
• 33. Zujko ME, Witkowska AM, Waśkiewicz A, Mirończuk-Chodakowska IJOM, Longevity C. Dietary antioxidant and flavonoid intakes are reduced in the elderly. 2015;2015.
• 34. Khalil A, Gaudreau P, Cherki M, Wagner R, Tessier DM, Fulop T, et al. Antioxidant-rich food intakes and their association with blood total antioxidant status and vitamin C and E levels in community-dwelling seniors from the Quebec longitudinal study NuAge. 2011;46(6):475-81.
• 35. Wu X, Gu L, Holden J, Haytowitz DB, Gebhardt SE, Beecher G, et al. Development of a database for total antioxidant capacity in foods: a preliminary study. 2004;17(3-4):407-22.
• 36. Puchau B, Zulet MA, de Echávarri AG, Hermsdorff HHM, Martínez JAJJotACoN. Dietary total antioxidant capacity: a novel indicator of diet quality in healthy young adults. 2009;28(6):648-56.
• 37. Floegel A, Kim D-O, Chung S-J, Song WO, Fernandez ML, Bruno RS, et al. Development and validation of an algorithm to establish a total antioxidant capacity database of the US diet. 2010;61(6):600-23.
• 38. Halvorsen BL, Holte K, Myhrstad MC, Barikmo I, Hvattum E, Remberg SF, et al. A systematic screening of total antioxidants in dietary plants. 2002;132(3):461-71.
• 39. Bahadoran Z, Golzarand M, Mirmiran P, Shiva N, Azizi FJN, metabolism. Dietary total antioxidant capacity and the occurrence of metabolic syndrome and its components after a 3-year follow-up in adults: Tehran Lipid and Glucose Study. 2012;9(1):1-9.
• 40. Rautiainen S, Lindblad BE, Morgenstern R, Wolk AJJo. Total antioxidant capacity of the diet and risk of age-related cataract: a population-based prospective cohort of women. 2014;132(3):247-52.
• 41. Asghari G, Yuzbashian E, Shahemi S, Gaeini Z, Mirmiran P, Azizi FJEjon. Dietary total antioxidant capacity and incidence of chronic kidney disease in subjects with dysglycemia: Tehran Lipid and Glucose Study. 2018;57(7):2377-85.
• 42. Pantavos A, Ruiter R, Feskens EF, de Keyser CE, Hofman A, Stricker BH, et al. Total dietary antioxidant capacity, individual antioxidant intake and breast cancer risk: the R otterdam study. 2015;136(9):2178-86.
• 43. Zujko ME, Witkowska AM, Waśkiewicz A, Piotrowski W, Terlikowska KMJNJ. Dietary antioxidant capacity of the patients with cardiovascular disease in a cross-sectional study. 2015;14(1):1-13.
• 44. Henríquez-Sánchez P, Sánchez-Villegas A, Ruano-Rodríguez C, Gea A, Lamuela-Raventós RM, Estruch R, et al. Dietary total antioxidant capacity and mortality in the PREDIMED study. 2016;55(1):227-36.
• 45. Tajbakhsh R, Qorbani M, Mehrpour G, Rahimzadeh M, Azimzadeh MM, Mirmiranpour HJSJoKD, et al. Effect of hemodialysis on oxidants and antioxidant factors in chronic renal failure. 2017;28(3):507.
• 46. da Silva BR, Gonzalez MC, Cereda E, Prado CMJN. Exploring the potential role of phase angle as a marker of oxidative stress: A narrative review. 2022;93:111493.
• 47. Harasym J, Oledzki RJN. Effect of fruit and vegetable antioxidants on total antioxidant capacity of blood plasma. 2014;30(5):511-7.
• 48. Tsuruya K, Eriguchi M, Yamada S, Hirakata H, Kitazono TJBP. Cardiorenal syndrome in end-stage kidney disease. 2015;40(4):337-43.
• 49. Giaretta AG, Schulz M, Silveira TT, de Oliveira MV, Patrício MJ, Gonzaga LV, et al. Apple intake improves antioxidant parameters in hemodialysis patients without affecting serum potassium levels. Nutrition Research. 2019;64:56-63.
• 50. Delmastro-Greenwood M, Freeman BA, Wendell SGJArop. Redox-dependent anti-inflammatory signaling actions of unsaturated fatty acids. 2014;76:79.
• 51. Furukawa S, Fujita T, Shimabukuro M, Iwaki M, Yamada Y, Nakajima Y, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. 2017;114(12):1752-61.
• 52. Friedman AN, Fadem SZJJotASoN. Reassessment of albumin as a nutritional marker in kidney disease. 2010;21(2):223-30.