Abstract
Background and Objectives: Diabetes mellitus (DM) and hypertension (HT) are characterized by cell damage caused by inflammatory and metabolic mechanisms induced by alteration in reduction-oxidative status. Serum advanced oxidation protein products (AOPP) are new markers of protein damage induced by oxidative stress. We evaluated serum levels of AOPP in a cohort of patients with DM and HT, with or without renal complications, compared with a control healthy population. Materials and Methods: The study group comprised of 62 patients with type 2 DM and 56 with HT. The 62 patients affected by DM were further distinguished in 24 subjects without renal impairment, 18 with diabetic nephropathy (DN), 20 with chronic kidney disease (CKD) stage 2–3 secondary to DN. The subgroup of 56 patients with primary HT comprised 26 subjects without renal complications and 30 with CKD (stage 2–3) secondary to HT. Thirty healthy controls, matched for age and sex, were recruited among blood donors. Results: Increased AOPP levels were found in DM patients compared with healthy subjects, although not significantly. This index was higher and more significant in patients with DN and CKD secondary to DN than in DM patients without nephropathy (p < 0.05) or controls (p < 0.0001). Patients with HT and with kidney impairment secondary to HT also had significantly higher AOPP serum levels than controls (p < 0.01 and p < 0.0001, respectively). There were no significant differences in mean AOPP levels among DM and HT patients. Conclusion: Our study showed that oxidative stress was higher in diabetic or hypertensive subjects than in healthy controls and, in particular, it appeared to be more severe in patients with renal complications. We suggest that the assessment of AOPP in diabetic and hypertensive patients may be important to predict the onset of renal failure and to open a new perspective on the adoption of antioxidant molecules to prevent CKD in those settings.
Highlights
End-stage renal disease (ESRD) is a serious health problem in the developed world
Diabetic nephropathy (DN) is one of the major chronic complications of diabetes mellitus and is associated with increased mortality as well as the risk of progression to ESRD, requiring renal replacement therapy [5]. Several studies performed both in vitro and in vivo suggest that oxidative stress is increased in diabetic animal models and patients, and it may contribute to the pathogenesis of diabetic nephropathy [6,7]
The mean plasma titer of advanced oxidation protein products (AOPP) was higher in diabetes mellitus (DM) patients compared to healthy subjects, but these findings did not reach a statistical significance
Summary
End-stage renal disease (ESRD) is a serious health problem in the developed world. Prevalence of ESRD secondary to diabetes mellitus (DM) and hypertension (HT) continues to increase more than by any other cause, as described in various reports in the United States and Europe [1]. Diabetic nephropathy (DN) is one of the major chronic complications of diabetes mellitus and is associated with increased mortality as well as the risk of progression to ESRD, requiring renal replacement therapy [5] Several studies performed both in vitro and in vivo suggest that oxidative stress is increased in diabetic animal models and patients, and it may contribute to the pathogenesis of diabetic nephropathy [6,7]. Results: Increased AOPP levels were found in DM patients compared with healthy subjects, not significantly This index was higher and more significant in patients with DN and CKD secondary to DN than in DM patients without nephropathy (p < 0.05) or controls (p < 0.0001). Patients with HT and with kidney impairment secondary to HT had significantly higher AOPP serum levels than controls (p < 0.01 and p < 0.0001, respectively)
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