The effect of low protein with moderate B-vitamin formula on renal function, homocysteine, oxidative stress and antioxidant capacities in patients with chronic kidney disease

• Main Authors: Yu-Hua Hsiao, 蕭郁樺
• Other Authors: 黃怡嘉
• Format: Others
• Language: zh-TW
• Published: 2015
• Online Access: http://ndltd.ncl.edu.tw/handle/80813126786709267900

碩士 === 中山醫學大學 === 營養學研究所 === 103 === Hyperhomocysteinemia and increased oxidative stress have been observed in patients with chronic kidney disease (CKD), both may further affect pateints’ renal function and antioxidant capacities. The purpose of this study was to evaluate the effect of low protein and moderate B-vitamin formula on renal function, homocysteine concentration, oxidative stress and antioxidant capacities in patients with stage 2-3 CKD. We recruited 100 stage 2-3 CKD patients from the outpatient clinic of the division of nephrology of Taichung Veterans General Hospital. Subjects were randomly assigned to a intervention group or observation group. Subjects in intervention group were asked to take 2 packs of low protein with moderate B-vitamin formula to replace their drink of breakfast or snack for 24 weeks. The hematological and urine samples were measured at the 0, 12th, and 24th week. Subjects in the observation group had significantly higher plasma homocysteine concentration at the 24th week when compared to the value at week 0; while plasma homocysteine concentration had no significant changes during the study period in the observation group. The levels of estimated glomerular filtration rate and malondialdehyde (oxidative stress indicators) at week 24 were significantly lower than week 0 in both groups. Serum creatinine concentration and glutathione reductase activity had no significant changes during the intervention study period in both groups, but the activities of the glutathione transferase, glutathione peroxidase and superoxide dismutase were significantly higher at week 24 when compare with activities at week 0. The change of glutathione peroxidase activity between week 24 and week 0 (#week 24-week 0) was significantly higher in the intervention group when compared to the value of the observation group. The change of glutathione and oxidized glutathione concentration between week 24 and week 0 (#week 24-week 0) was significantly lower in the intervention group when compared to the value of the observation group. After adjusting for age, gender, body mass index, diabetes mellitus, hypertension, smoking and drinking habits, formula hade significant effect on reducing the change of glutathione concentration (B = -59.75, p < 0.01) and oxidized glutathione concentration (B = -56.80, p < 0.01) and increasing the change of glutathione peroxidase activity (B = 59.94, p < 0.01). The intervention of low protein with moderate B-vitamin formula had no significant beneficial effect on changing renal function, homocysteine concentration and oxidative stress; however it could significantly increase the activity of glutathione peroxidase and decrease glutathione and oxidized glutathione concentration.