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Esgalhado M, Stenvinkel P, Mafra D. Nonpharmacologic Strategies to Modulate Nuclear Factor Erythroid 2–related Factor 2 Pathway in Chronic Kidney Disease. J Ren Nutr 2017; 27:282-291. [DOI: 10.1053/j.jrn.2017.01.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/03/2016] [Accepted: 01/06/2017] [Indexed: 01/25/2023] Open
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Pedruzzi LM, Cardozo LFMDF, Medeiros RF, Stockler-Pinto MB, Mafra D. Association between serum ferritin and lipid peroxidation in hemodialysis patients. J Bras Nefrol 2017; 37:171-6. [PMID: 26154636 DOI: 10.5935/0101-2800.20150028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 02/10/2015] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Iron supplementation is one of the recommendations found in patients with chronic kidney disease (CKD), however, an overload of this mineral can contribute to oxidative stress, a condition closely related to the cardiovascular risk in these patients, as well as disease progression. OBJECTIVE The objective of this study was to investigate whether ferritin levels are associated with oxidative stress marker MDA in patients on hemodialysis (HD). METHODS Twenty HD patients (55.0 ± 15.2 years, time of dialysis 76.5 ± 46.3 months, BMI 23.6 ± 3.0 kg/m2) were compared with 11 healthy subjects (50.9 ± 8.0 years, BMI 23.8 ± 1.9 kg/m2). Malondialdehyde (MDA) was measured by reaction with thiobarbituric acid and routine biochemical data were obtained from medical records. RESULTS MDA levels were significantly higher in HD patients compared to the control group (13.2 ± 5.3 nmol/mL vs. 5.1 ± 2.7nmol/mL, p < 0.01). Twelve patients (60%) had ferritin values greater than the 500 ng/mL and there was a positive correlation between ferritin and MDA in HD (r = 0.66, p = 0.005, n = 17) patients. CONCLUSION The excess iron stores in HD patients results in increased lipid peroxidation, and consequently contributes to increased oxidative stress in these patients.
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Brito JS, Borges NA, Esgalhado M, Magliano DC, Soulage CO, Mafra D. Aryl Hydrocarbon Receptor Activation in Chronic Kidney Disease: Role of Uremic Toxins. Nephron Clin Pract 2017; 137:1-7. [PMID: 28490014 DOI: 10.1159/000476074] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 04/21/2017] [Indexed: 11/19/2022] Open
Abstract
The aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor involved in the expression of xenobiotic-metabolizing enzymes, inflammatory cytokines and adhesion molecules. Uremic toxins such as indoxyl sulfate and indole acetic acid are derived from tryptophan fermentation by gut microbiota; they accumulate in patients with chronic kidney disease (CKD) on haemodialysis and have recently emerged as potent ligands of AhR. Therefore, AhR can serve as a mediator in inflammation and cardiovascular diseases in these patients. This review discusses current data that support a link between AhR activation and uremic toxins from gut microbiota in CKD.
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Mafra D, Fontes B, Mendes de Vargas DC, Santos da Silva G, Black Veiga AP, Saraiva dos Anjos J. MP445EFFECTS OF LOW PROTEIN DIET ON THE BIOCHEMICAL AND ANTHROPOMETRIC PROFILES OF CHRONIC KIDNEY DISEASE PATIENTS. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx172.mp445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mafra D, Alvarenga Borges N, Nakau L, Dolenga C, Bergman P, Stenvinkel P. MP431EFFECTS OF PROBIOTIC SUPPLEMENTATION ON UREMIC TOXINS LEVELS IN NON-DIALYSIS CKD PATIENTS. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx172.mp431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mafra D, Black AP, Santos da Silva G, Mendes de Vargas DC, Saraiva dos Anjos J. MP430DIETARY PROTEIN INTAKE IS ASSOCIATED WITH NUCLEAR FACTOR-KB EXPRESSION IN NON-DIALYSIS CHRONIC KIDNEY DISEASE PATIENTS. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx172.mp430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mafra D, da Silva Moura DC, Saraiva dos Anjos J, Black Veiga AP. SP420IS THERE RELATIONSHIP BETWEEN BODY COMPOSITION AND BONE MINERAL DENSITY IN NON-DIALYSIS CKD PATIENTS? Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx148.sp420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mafra D, Black Veiga AP, Saraiva dos Anjos J, Stenvinkel P, Bergman P, Moraes C. MP449EFFECT OF LOW PROTEIN DIET ON TRIMETHYLAMINE-N-OXIDE PLASMA LEVELS IN NON-DIALYSIS CHRONIC KIDNEY DISEASE PATIENTS. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx172.mp449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Marinho S, Carraro Eduardo J, Mafra D. Effect of a resistance exercise training program on bone markers in hemodialysis patients. Sci Sports 2017. [DOI: 10.1016/j.scispo.2017.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Marinho SM, Moraes C, Barbosa JEDSM, Carraro Eduardo JC, Fouque D, Pelletier S, Mafra D. Exercise Training Alters the Bone Mineral Density of Hemodialysis Patients. J Strength Cond Res 2016; 30:2918-23. [PMID: 26863587 DOI: 10.1519/jsc.0000000000001374] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Marinho, SM, Moraes, C, Barbosa, JEdSM, Eduardo, JCC, Fouqe, D, Pelletier, S, and Mafra, D. Exercise training alters the bone mineral density of hemodialysis patients. J Strength Cond Res 30(10): 2918-2923, 2016-Patients with chronic kidney disease undergoing hemodialysis (HD) frequently present low bone mineral density (BMD), and exercise may be useful for treating bone loss. This study aimed to assess the effects of an intradialytic resistance exercise training program (RETP) on BMD in HD patients. Twenty-one patients were enrolled into 2 groups; 10 patients performed exercise (80.0% men; 46.9 ± 12.1 years; 27.0 ± 3.4 kg·m) and 11 patients were in the control group (54.5% men; 50.5 ± 11.5 years; 24.1 ± 8.7 kg·m). Dual-energy x-ray absorptiometry was used to measure the BMD, lean mass, and body fat before and after the supervised RETP (performed with elastic bands and ankle cuffs in both lower limbs 3 times a week for 24 weeks-72 sessions). In the exercise group, 30.0% of patients presented with osteopenia and 20.0% osteoporosis and in the control group, 45.5% osteopenia and 36.4% osteoporosis. Only in the exercise group, the osteoporosis percentage was reduced to 10.0% and the femoral neck BMD and T-score improved from 0.89 ± 0.1 to 0.93 ± 0.1 g·cm and from -1.3 ± 0.8 to -1.0 ± 0.8 g·cm (p ≤ 0.05), respectively, after the intervention. In contrast, these parameters were reduced in the control group. The results suggest that resistance exercise may be useful for improving the BMD in HD patients. In summary, 24 weeks of the supervised RETP played a role in improving the BMD of HD patients.
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Janiques AGDPR, Leal VDO, Stockler-Pinto MB, Moreira NX, Mafra D. Effects of grape powder supplementation on inflammatory and antioxidant markers in hemodialysis patients: a randomized double-blind study. J Bras Nefrol 2016; 36:496-501. [PMID: 25517279 DOI: 10.5935/0101-2800.20140071] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 07/24/2014] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Polyphenols contained in natural sources such as grapes, have been considered pharmacological agents to combat oxidative stress and inflammation, common features in Chronic Kidney Disease patients. OBJECTIVE To evaluate the effects of grape powder supplementation on inflammatory and antioxidant biomarkers in hemodialysis (HD) patients. METHODS The double-blind placebo-controlled randomized clinical trial evaluated non-diabetic HD patients that received grape powder (500 mg of polyphenols/day) (n = 16, 9 men, 53.0 ± 9.8 years of age, 111.6 ± 58.2 HD months) or placebo (n = 16, 9 men, 52.7 ± 13.7 years of age, 110.4 ± 93.1 HD months) for five weeks. The glutathione peroxidase (GSH-Px) activity and C-reactive protein (CRP) levels were evaluated by ELISA method. RESULTS After the intervention period, the patients receiving grape powder showed an increase in the GSH-Px activity (16.5 (41.0) to 42.0 (43.3) nmol/min/ml) (p < 0.05) and they did not have the CRP levels increased as seen in placebo group (2.6 (0.28) to 2.8 (0.23 mg/L) (p < 0.05). CONCLUSION The use of grape powder as phenolic source could play an important role as an antioxidant and anti-inflammatory agent in non-diabetic HD patients.
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Stockler-Pinto MB, Malm O, Azevedo SRG, Farage NE, Dorneles PR, Cozzolino SMF, Mafra D. Selenium plasma levels in hemodialysis patients: comparison between North and Southeast of Brazil. J Bras Nefrol 2016; 36:490-5. [PMID: 25517278 DOI: 10.5935/0101-2800.20140070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 08/28/2014] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Patients with chronic kidney disease present selenium (Se) plasma deficiency which is an essential trace element with important biological functions and, the best known biological role is attributed to its presence in the antioxidant enzyme, glutathione peroxidase (GPx). The Se content of foods depends on soil and some authors have suggested that Amazon soil (North Brazilian region) has high Se concentrations when compared to other regions of Brazil. OBJECTIVE The objective of this work was to compare the Se status in hemodialysis (HD) patients from North and Southeast of Brazil. METHODS Thirty-eight patients from Southeast region (22 men and 16 women, 15% diabetic, 53.5 ± 26.4 yrs) were compared to 40 patients from North region (28 men and 12 women, 22.5% diabetic, 63.5 ± 11.9 yrs). Se in plasma was determined through atomic absorption spectrophotometry with hydride generation. RESULTS The plasma Se levels in patients from Southeast region were significantly lower (17.5 ± 11.9 μg/L) when compared to patients from the North (37.1 ± 15.8 μg/L) (p < 0.001). However, both patient groups presented low Se plasma levels when compared to recommended values (60- 120 μg/L). There was no correlation between plasma Se levels and analyzed parameters. CONCLUSION We concluded that patients from North (Amazon) region present higher plasma Se levels when compared to the patients from Southeast of Brazil. However, independently of the region, HD patients presented Se deficiency.
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Borges NA, Barros AF, Nakao LS, Dolenga CJ, Fouque D, Mafra D. Protein-Bound Uremic Toxins from Gut Microbiota and Inflammatory Markers in Chronic Kidney Disease. J Ren Nutr 2016; 26:396-400. [DOI: 10.1053/j.jrn.2016.07.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 07/20/2016] [Accepted: 07/31/2016] [Indexed: 11/11/2022] Open
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Saldanha JF, Leal VO, Rizzetto F, Grimmer GH, Ribeiro-Alves M, Daleprane JB, Carraro-Eduardo JC, Mafra D. Effects of Resveratrol Supplementation in Nrf2 and NF-κB Expressions in Nondialyzed Chronic Kidney Disease Patients: A Randomized, Double-Blind, Placebo-Controlled, Crossover Clinical Trial. J Ren Nutr 2016; 26:401-406. [PMID: 27523436 DOI: 10.1053/j.jrn.2016.06.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 06/09/2016] [Accepted: 06/11/2016] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Resveratrol is a phenolic compound that has demonstrated anti-inflammatory and antioxidant effects, resulting from enhanced antioxidant enzymes production and modulating nuclear factors involved in the inflammation-oxidative stress cycle, as nuclear erythroid 2-related factor 2 (Nrf2) and nuclear factor-κB (NF-κB). OBJECTIVE The study aim was to evaluate the effects of resveratrol supplementation on Nrf2 and NF-κB expression in nondialyzed chronic kidney disease (CKD) patients. MATERIALS AND METHODS A randomized, double-blind, crossover trial was performed in 20 nondialyzed CKD patients (62.0 ± 8.0 years old, 45% men, body mass index of 27.7 ± 1.2 kg/m2, estimated glomerular filtration rate of 34.0 ± 13.0 mL/minute). Eleven patients were randomly allocated to "placebo first" (4 weeks placebo; 8 weeks washout, 4 weeks 500 mg of resveratrol/day) and 9 to "resveratrol first" (4 weeks 500 mg of resveratrol/day, 8 weeks washout, 4 weeks placebo). The peripheral blood mononuclear cells were isolated and processed for expression Nrf2 and NF-κB by quantitative real-time polymerase chain reaction. Proinflammatory cytokines and antioxidant enzymes were also measured. RESULTS The effect size of Nrf2 supplementation (-0.13, P = .29) and NF-κB (0.09, P = .31) was not significant. There was no difference in proinflammatory biomarkers or antioxidant biomarkers after resveratrol supplementation. CONCLUSION In this pilot study, 500 mg of resveratrol supplementation for 4 weeks had no antioxidant and anti-inflammatory effect in nondialyzed CKD patients. Additional studies with differing doses and/or time of treatment should be conducted to better elucidate the effects of the resveratrol supplementation in CKD patients.
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Abstract
BACKGROUND Chronic kidney disease (CKD) is an emerging health public problem in Brazil. Nutritional counseling with focus on protein restriction is a promising strategy to treatment of nondialysis CKD patients due its effects on slowing renal loss. However, Brazilian people have high protein intake, which is a challenge when low protein diet (LPD) should be prescribed. This review describes a practical approach to the dietetic management of nondialysis CKD patients in Brazil. DISCUSSION Although Brazilian cuisine varies greatly by region, Brazil has current trends of incorporating Western dietary habits, including high intake of red meat. Traditional plant-based foods, such as rice and beans, are also important contributors to the high protein content to the Brazilian diet. Thus, a successful implementation of LPD requires adaptation of these dietary habits, with reduction of portion sizes and adequate food substitution options. Intensive nutritional counseling with specialized renal dietitians is also important to improve compliance to the LPD. Moreover, the precarious health system organization and economic problems are barriers to nutritional care, which could be solved with intensive and specialized perspectives of treatment. The adherence to protein restriction is important for better metabolic and clinical control of nondialysis CKD patients. Early dietetic attention, nutrition education strategies and intensive specialized nutritional counseling are essential to achieve diet habits that promote adherence to the LPD without excluding cultural characteristics of the Brazilian diet.
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Esgalhado M, Borges NA, Mafra D. Could physical exercise help modulate the gut microbiota in chronic kidney disease? Future Microbiol 2016; 11:699-707. [DOI: 10.2217/fmb.16.12] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Chronic kidney disease (CKD) patients have several metabolic disorders caused by chronic oxidative stress and inflammation. The imbalance of gut microbiota has been identified as a factor that may contribute to the development of these disorders, which can promote cardiovascular disease in CKD patients. Among several strategies to modulate gut microbiota, physical exercise could represent a new nonpharmacological approach. Although exercise can reduce cardiovascular risk in CKD patients through its beneficial effects on oxidative stress and inflammation, there are no available data regarding the relationship between exercise and modulation of gut microbiota in CKD patients. This review is intended to provide a brief overview of the hypothesis regarding gut microbiota modulation through physical exercise, with a particular emphasis on CKD.
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Marinho SMSDA, Mafra D, Pelletier S, Hage V, Teuma C, Laville M, Carraro Eduardo JC, Fouque D. In Hemodialysis Patients, Intradialytic Resistance Exercise Improves Osteoblast Function: A Pilot Study. J Ren Nutr 2016; 26:341-5. [PMID: 27113628 DOI: 10.1053/j.jrn.2016.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 03/14/2016] [Accepted: 03/14/2016] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Abnormalities in mineral and bone metabolism are frequent in chronic kidney disease patients. Physical exercise can improve many indicators of physical functioning, and recent studies showed beneficial effects on bone mineral density in the general population. The aim of this study was to evaluate the effects of resistance exercise training on bone markers and body composition in hemodialysis (HD) patients. DESIGN This was a randomized controlled trial. SUBJECTS The study included 13 HD patients (46.2% men). INTERVENTION Patients were divided into a control group and an exercise group, which performed 8 weeks of intradialytic resistance exercise. Serum sclerostin, bone alkaline phosphatase (BAP), insulin, leptin, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and body composition were measured before and after the exercise period. RESULTS In the exercise group, BAP levels increased from 11.4 ± 6.5 to 14.6 ± 6.4 U/L (P < .05) and serum 1,25-dihydroxyvitamin D levels from 46.0 ± 23.5 to 87.2 ± 31.8 ng/mL (P < .05). After exercise, serum BAP levels were inversely correlated with serum sclerostin (r = -0.96, P < .05). There was no change in body composition in either group. CONCLUSION Resistance exercise training appears to be an interesting approach for stimulating BAP production in HD patients and may prevent bone loss and stimulate bone formation.
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Cardozo LFMF, Stockler-Pinto MB, Mafra D. Brazil nut consumption modulates Nrf2 expression in hemodialysis patients: A pilot study. Mol Nutr Food Res 2016; 60:1719-24. [DOI: 10.1002/mnfr.201500658] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 02/23/2016] [Accepted: 02/26/2016] [Indexed: 11/07/2022]
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Saldanha JF, Yi D, Stockler-Pinto MB, Soula HA, Chambert S, Fouque D, Mafra D, Soulage CO. Determination of the binding properties of the uremic toxin phenylacetic acid to human serum albumin. Biochimie 2016; 125:53-8. [PMID: 26945842 DOI: 10.1016/j.biochi.2016.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/01/2016] [Indexed: 12/21/2022]
Abstract
Uremic toxins are compounds normally excreted in urine that accumulate in patients with chronic kidney disease as a result of decreased renal clearance. Phenylacetic acid (PAA) has been identified as a new protein bound uremic toxin. The purpose of this study was to investigate in vitro the interaction between PAA and human serum albumin (HSA) at physiological and pathological concentrations. We used ultrafiltration to show that there is a single high-affinity binding site for PAA on HSA, with a binding constant on the order of 3.4 × 10(4) M(-1) and a maximal stoichiometry of 1.61 mol per mole. The PAA, at the concentration reported in end-stage renal patients, was 26% bound to albumin. Fluorescent probe competition experiments demonstrated that PAA did not bind to Sudlow's site I (in subdomain IIA) and only weakly bind to Sudlow's site II (in subdomain IIIA). The PAA showed no competition with other protein-bound uremic toxins such as p-cresyl-sulfate or indoxyl sulfate for binding to serum albumin. Our results provide evidence that human serum albumin can act as carrier protein for phenylacetic acid.
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de Souza Rocha G, da Silva Ferreira R, da Matta Alvarez Pimenta N, Monteiro da Fonseca L, Mafra D, Blondet V, de Souza da Fonseca A, Girão Barroso S. Effects of resveratrol, grape juice or red wine consumption Irisin levels and fibronectin type III domain containing protein 5 and uncoupoling protein gene expression modulation in rats. CLINICAL NUTRITION EXPERIMENTAL 2016. [DOI: 10.1016/j.yclnex.2016.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Stockler-Pinto MB, Saldanha JF, Yi D, Mafra D, Fouque D, Soulage CO. The uremic toxin indoxyl sulfate exacerbates reactive oxygen species production and inflammation in 3T3-L1 adipose cells. Free Radic Res 2016; 50:337-44. [PMID: 26617268 DOI: 10.3109/10715762.2015.1125996] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Inflammation and oxidative stress are common features of patients with chronic kidney disease (CKD) and many uremic solutes retained in these patients could be involved in these processes, among which protein-bound solutes such as indoxyl sulfate (IS). White adipose tissue recently gained attention as an important source of inflammation and oxidative stress. To examine the effect of IS on adipocytes, 3T3-L1 adipose cells were incubated with IS to mimic the conditions encountered in uremic patients. Incubation of adipose cells with IS increased reactive oxygen species production generated mainly through activation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase since it was prevented by the NADPH oxidase inhibitor apocynin. Exposure to IS furthermore exacerbated the secretion of tumor necrosis factor-α and interleukin-6 by adipose cells. This inflammatory response was prevented by NADPH oxidase inhibition pinpointing the pivotal role of intracellular oxidative stress. IS induces adipocyte perturbation and promotes inflammatory state mainly through induction of oxidative stress. IS, a uremic toxin, accumulates in CKD patients could, therefore, be an important mediator of adipocyte dysfunction in these patients.
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Barros AF, Borges NA, Ferreira DC, Carmo FL, Rosado AS, Fouque D, Mafra D. Is there interaction between gut microbial profile and cardiovascular risk in chronic kidney disease patients? Future Microbiol 2016; 10:517-26. [PMID: 25865191 DOI: 10.2217/fmb.14.140] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
AIM To evaluate the gut microbial profile in chronic kidney disease (CKD) patients and evaluate the possible relationship with inflammation and cardiovascular risk. PATIENTS & METHODS Markers inflammation plasma and bacterial community profile (denaturing gradient gel electrophoresis) were analyzed. RESULTS The average number of bands was not different in healthy individuals and CKD patients. The number of bands was negatively associated with plasma levels of VCAM-1 in patients. Flavobacteriaceae bacterium and Listeria monocytogenes were found in patients and Lachnospiraceae bacterium and Butyrivibrio crossotus in healthy individuals. CONCLUSION Although CKD patients did not present altered gut microbial profile, the sequencing of bands suggested a different microbiota between groups. The result suggests a possible relationship between gut microbiota and cardiovascular risk in CKD patients.
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Brito JSD, Borges NA, Dolenga CJR, Carraro-Eduardo JC, Nakao LS, Mafra D. Is there a relationship between tryptophan dietary intake and plasma levels of
indoxyl sulfate in chronic kidney disease patients on hemodialysis? J Bras Nefrol 2016; 38:396-402. [DOI: 10.5935/0101-2800.20160064] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 06/13/2016] [Indexed: 11/20/2022] Open
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Moraes C, Fouque D, Amaral ACF, Mafra D. Trimethylamine N-Oxide From Gut Microbiota in Chronic Kidney Disease Patients: Focus on Diet. J Ren Nutr 2015; 25:459-65. [DOI: 10.1053/j.jrn.2015.06.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 06/05/2015] [Accepted: 06/13/2015] [Indexed: 01/23/2023] Open
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Leal VO, Saldanha JF, Stockler-Pinto MB, Cardozo LFMF, Santos FR, Albuquerque ASD, Leite M, Mafra D. NRF2 and NF-κB mRNA expression in chronic kidney disease: a focus on nondialysis patients. Int Urol Nephrol 2015; 47:1985-91. [PMID: 26490557 DOI: 10.1007/s11255-015-1135-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 10/07/2015] [Indexed: 12/26/2022]
Abstract
PURPOSE To evaluate nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear factor-kappaB (NF-κB) mRNA expression in nondialysis chronic kidney disease (CKD) patients, comparing with data from hemodialysis (HD) patients and healthy individuals. METHODS Twenty nondialysis CKD patients (62.0 ± 8.1 years old, 11 men, estimated glomerular filtration rate of 36.8 ± 13.6 mL/min/1.73 m(2)), twenty HD patients (55.0 ± 15.2 years old, 13 men, and dialysis vintage of 76.5 ± 46.3 months) and eleven healthy individuals (50.9 ± 8.0 years old, 6 men) were enrolled in the study. The peripheral blood mononuclear cells were isolated and processed for the evaluation of expression of NF-κB and Nrf2 by quantitative real-time polymerase chain reaction. RESULTS Nrf2 mRNA expression was significantly higher in nondialysis (1.12 ± 0.57) when compared to HD patients (0.58 ± 0.35, p = 0,006) but similar to healthy individuals (1.13 ± 0.64). Inversely, NF-κB mRNA expression was lower in nondialysis (1.21 ± 0.71) when compared to HD patients (2.08 ± 0.7, p < 0.0001) and similar to healthy individuals (1.04 ± 0.22). Nrf2 mRNA was positively correlated with NF-κB mRNA expression in nondialysis CKD patients (r = 0.52, p = 0.02) and healthy individuals (r = 0.77, p < 0.006). By contrast, Nrf2 mRNA was inversely correlated with NF-κB mRNA expression (r = -0.65, p = 0.003) in HD patients. CONCLUSION Nondialysis CKD patients may conserve regular homeostatic balance between Nrf2 and NF-κB expressions, being comparable to healthy individuals. However, HD patients seem to have Nrf2 downregulation and NF-κB upregulation. Thus, the association among Nrf2 and NF-κB expressions and nutritional status, kidney disease progression or immune deregulation deserve further investigation.
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