A Pilot Study of a Natural Food Supplement as New Possible Therapeutic Approach in Chronic Kidney Disease Patients.

Annalisa Noce,Alessio Bocedi,Manuela Di Lauro,Margherita Campo,Nicola Di Daniele,Annalisa Romani,Giada Cattani,Giulia Marrone

doi:10.3390/ph13070148

Abstract

The identification of natural bioactive compounds, able to counteract the abnormal increase of oxidative stress and inflammatory status in chronic degenerative non-communicable diseases is useful for the clinical management of these conditions. We tested an oral food supplement (OFS), chemically characterized and evaluated for in vitro and in vivo activity. Vitamin C, analyzed by High Performance Liquid Chromatography-Diode Array Detector (HPLC-DAD), was 0.19 mg/g in rosehip dry extract and 15.74 mg/capsule in the OFS. The identification of polyphenols was performed by HPLC-DAD; the total antioxidant capacity was assessed by Folin–Ciocalteu test. Total polyphenols were 14.73 mg/g gallic acid equivalents (GAE) for rosehip extract and 1.93 mg/g GAE for OFS. A total of 21 chronic kidney disease (CKD) patients and 10 healthy volunteers were recruited. The evaluation of routine laboratory and inflammatory parameters, erythrocyte glutathione transferase (e-GST), human oxidized serum albumin (HSAox), and assessment of body composition were performed at two different times, at baseline and after 5 weeks of OFS assumption. In the study, we highlighted a significant decrease of traditional inflammatory biomarkers (such as C-reactive protein, erythrocyte sedimentation rate, platelet to lymphocyte ratio) and other laboratory parameters like e-GST, azotaemia, and albuminuria after OFS treatment in CKD patients. Moreover, we demonstrated a lipid profile improvement in CKD patients after OFS supplementation.

Highlights

Chronic kidney disease (CKD) is a major health problem with a considerable worldwide impact and the onset is correlated to the spread of its risk factors such as obesity, metabolic syndrome, arterial hypertension, and diabetes mellitus (DM) [1,2].chronic kidney disease (CKD) is directly related with cardiovascular (CV) mortality and morbidity
For evaluation of inflammatory status we examined the C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR) [27]
We highlighted that the assumption of oral food supplement (OFS) Siuper® for 5 weeks significantly decreases traditional inflammatory biomarkers such as CRP, ESR, and a new biomarker of inflammatory status such as PLR

Summary

Introduction

Chronic kidney disease (CKD) is a major health problem with a considerable worldwide impact and the onset is correlated to the spread of its risk factors such as obesity, metabolic syndrome, arterial hypertension, and diabetes mellitus (DM) [1,2]. CKD is directly related with cardiovascular (CV) mortality and morbidity. The latter displayed a 10 to 20-fold increase respect to general population [3,4]. Uremic CV risk factors that exert a key role are chronic low-grade inflammatory status [5], alteration of calcium-phosphorus metabolism [6,7,8,9], hyperhomocysteinemia [10], malnutrition [11], uremic sarcopenia [12,13,14], and oxidative stress (OS) [15,16]. The increased concentration of pro-oxidant substances influences cellular communication; in the kidney it promotes apoptosis and cell senescence, determining reduced regenerative cellular capacity and fibrosis [18,19]

Objectives

Methods

Results

Conclusion