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Da Cruz BO, Almeida PP, Silva-Costa N, Brito ML, Degani VAN, da Silva EM, Magliano DC, Mebarek S, Brizuela L, Cardozo LFMF, Stockler-Pinto MB. Brazil nut-enriched diet modulates bone mineral density and body composition in an experimental model of chronic kidney disease. Nutrition 2024; 125:112482. [PMID: 39024685 DOI: 10.1016/j.nut.2024.112482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 04/17/2024] [Accepted: 04/30/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVE This study investigates the effects of a Brazil nut-enriched diet on body composition and bone parameters in CKD animal model. METHODS Male Wistar rats were assigned to the following groups: Sham (n=8), Nx (n=6), nephrectomized rats, and NxBN (n=6), nephrectomized rats and an enricheddiet with 5% Brazil nut. Body composition parameters were obtained by dual-energy X- ray absorptiometry (DXA). Bioclin kits determined plasmatic calcium. The femurs werecollected to determine absolute mass and length, bone mineral density, and biomechanical tests. RESULTS The NxBN group exhibited a higher total body bone mineral density (BMD) value than the Nx group (0.177±0.004g/cm2vs 0,169±0.003g/cm2; p=0.0397). No significant differences were observed regarding absolute mass, length, BMD, and biomechanical parameters in the femurs of the groups. Moreover, no significant differences were found in plasmatic calcium levels among the groups. CONCLUSIONS Brazil-nut enriched diet modulated BMD in CKD experimental model, and further studies are demanded to understand the pathways involved in this finding.
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Affiliation(s)
- Beatriz Oliveira Da Cruz
- Cardiovascular Sciences Post Graduate Program, Universidade Federal Fluminense, Niterói-RJ, Brazil.
| | | | - Nathalia Silva-Costa
- Cardiovascular Sciences Post Graduate Program, Universidade Federal Fluminense, Niterói-RJ, Brazil
| | - Michele Lima Brito
- Pathology Post Graduate Program, Universidade Federal Fluminense, Niterói- RJ, Brazil
| | | | - Eduardo Moreira da Silva
- Analytical Laboratory of Restorative Biomaterials, Dental School, Universidade Federal Fluminense, Niterói-RJ, Brazil
| | - D'Angelo Carlo Magliano
- Pathology Post Graduate Program, Universidade Federal Fluminense, Niterói- RJ, Brazil; Research Center on Morphology and Metabolism, Department of Morphology, Biomedical Institute, Universidade Federal Fluminense, Niterói-RJ, Brazil
| | - Saida Mebarek
- Institut de Chimie et Biochimie Moléculaires et Supramoléculaires, Université Claude Bernard Lyon 1, Lyon, France
| | - Leyre Brizuela
- Institut de Chimie et Biochimie Moléculaires et Supramoléculaires, Université Claude Bernard Lyon 1, Lyon, France
| | - Ludmila F M F Cardozo
- Cardiovascular Sciences Post Graduate Program, Universidade Federal Fluminense, Niterói-RJ, Brazil
| | - Milena Barcza Stockler-Pinto
- Cardiovascular Sciences Post Graduate Program, Universidade Federal Fluminense, Niterói-RJ, Brazil; Pathology Post Graduate Program, Universidade Federal Fluminense, Niterói- RJ, Brazil; Nutrition Sciences Post Graduate Program, Universidade Federal Fluminense, Niterói-RJ, Brazil
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Imani PD, Vega M, Pekkucuksen NT, Srivaths P, Arikan AA. Vitamin D and metabolic bone disease in prolonged continuous kidney replacement therapy: a prospective observational study. BMC Nephrol 2024; 25:265. [PMID: 39160464 PMCID: PMC11334345 DOI: 10.1186/s12882-024-03705-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 08/09/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Complications of prolonged continuous kidney replacement therapy (CKRT) have not been well described. Our objective was to describe mineral metabolism and bone findings in children who required prolonged CKRT. METHODS In this single center prospective observational study, we enrolled 37 patients who required CKRT for ≥ 28 days with regional citrate anticoagulation. Exposure was duration on CKRT and outcomes were 25-hydroxy vitamin D and osteopenia and/or fractures. RESULTS The prevalence of vitamin D deficiency and insufficiency was 17.2% and 69.0%, respectively. 29.7% of patients had radiographic findings of osteopenia and/or fractures. There was no association between vitamin D deficiency or insufficiency with age or ethnicity. Time on CKRT and intact PTH levels were not predictive of vitamin D levels. Children with chronic liver disease were more likely to have osteopenia and/or fractures compared children with other primary diagnoses, odds ratio (3.99 (95%CI, 1.58-2.91), p = 0.003) after adjusting for age and time on CKRT. CONCLUSION Vitamin D deficiency and/or insufficiency, and osteopenia and/or fractures are prevalent among children who require CKRT for a prolonged period. The risk for MBD may be higher with chronic liver disease. Higher doses of vitamin D may be required to maintain normal levels while on CKRT.
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Affiliation(s)
- Peace Dorothy Imani
- Department of Pediatrics, Division of Pediatric Nephrology, Texas Children's Hospital, Baylor College of Medicine, 1102 Bates Avenue, Suite 245, Houston, TX, USA.
| | - Molly Vega
- Department of Pediatrics, Division of Pediatric Nephrology, Texas Children's Hospital, Baylor College of Medicine, 1102 Bates Avenue, Suite 245, Houston, TX, USA
| | | | - Poyyapakkam Srivaths
- Department of Pediatrics, Division of Pediatric Nephrology, Texas Children's Hospital, Baylor College of Medicine, 1102 Bates Avenue, Suite 245, Houston, TX, USA
| | - Ayse Akcan Arikan
- Department of Pediatrics, Division of Pediatric Nephrology, Texas Children's Hospital, Baylor College of Medicine, 1102 Bates Avenue, Suite 245, Houston, TX, USA
- Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
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Mace ML, Lewin E. Frontiers in Bone Metabolism and Disorder in Chronic Kidney Disease. Metabolites 2023; 13:1034. [PMID: 37887359 PMCID: PMC10608583 DOI: 10.3390/metabo13101034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023] Open
Abstract
Chronic Kidney Disease (CKD) is a progressive condition that affects 10-15% of the adult population, a prevalence expected to increase worldwide [...].
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Affiliation(s)
- Maria L. Mace
- Department of Nephrology, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Ewa Lewin
- Department of Nephrology, Herlev Hospital, University of Copenhagen, 2100 Copenhagen, Denmark;
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Plasma Nitrate and Nitrite Kinetics after Single Intake of Beetroot Juice in Adult Patients on Chronic Hemodialysis and in Healthy Volunteers: A Randomized, Single-Blind, Placebo-Controlled, Crossover Study. Nutrients 2022; 14:nu14122480. [PMID: 35745210 PMCID: PMC9228981 DOI: 10.3390/nu14122480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/09/2022] [Accepted: 06/12/2022] [Indexed: 11/16/2022] Open
Abstract
Nitric oxide (NO) contributes to maintaining normal cardiovascular and renal function. This bioactive signalling molecule is generally formed enzymatically by NO synthase in the vascular endothelium. NO bioactivity can also be attributed to dietary intake of inorganic nitrate, which is abundant in our diet, especially in green leafy vegetables and beets. Ingested nitrate is reduced to nitrite by oral commensal bacteria and further to NO systemically. Previous studies have shown that dialysis, by means of removing nitrate and nitrite from the body, can reduce NO bioactivity. Hence, dietary intervention approaches aimed to boost the nitrate-nitrite-NO pathway may be of benefit in dialysis patients. The purpose of this study was to examine the kinetics of plasma nitrate and nitrite after a single intake of nitrate-rich concentrated beetroot juice (BJ) in adult hemodialysis (HD) patients and in age-matched healthy volunteers (HV). Eight HD patients and seven HV participated in this single center, randomized, single-blind, placebo-controlled, crossover study. Each participant received a sequential single administration of active BJ (70 mL, 400 mg nitrate) and placebo BJ (70 mL, 0 mg nitrate) in a random order separated by a washout period of seven days. For the kinetic analysis, blood samples were collected at different time-points before and up to 44 h after BJ intake. Compared with placebo, active BJ significantly increased plasma nitrate and nitrite levels both in HD patients and HV. The area under the curve and the maximal concentration of plasma nitrate, but not of nitrite, were significantly higher in HD patients as compared with HV. In both groups, active BJ ingestion did not affect blood pressure or plasma potassium levels. Both BJs were well tolerated in all participants with no adverse events reported. Our data provide useful information in planning dietary nitrate supplementation efficacy studies in patients with reduced NO bioactivity.
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Mihajlovic M, Krebber MM, Yang Y, Ahmed S, Lozovanu V, Andreeva D, Verhaar MC, Masereeuw R. Protein-Bound Uremic Toxins Induce Reactive Oxygen Species-Dependent and Inflammasome-Mediated IL-1β Production in Kidney Proximal Tubule Cells. Biomedicines 2021; 9:biomedicines9101326. [PMID: 34680443 PMCID: PMC8533138 DOI: 10.3390/biomedicines9101326] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/19/2021] [Accepted: 09/23/2021] [Indexed: 12/29/2022] Open
Abstract
Protein bound-uremic toxins (PBUTs) are not efficiently removed by hemodialysis in chronic kidney disease (CKD) patients and their accumulation leads to various co-morbidities via cellular dysfunction, inflammation and oxidative stress. Moreover, it has been shown that increased intrarenal expression of the NLRP3 receptor and IL-1β are associated with reduced kidney function, suggesting a critical role for the NLRP3 inflammasome in CKD progression. Here, we evaluated the effect of PBUTs on inflammasome-mediated IL-1β production in vitro and in vivo. Exposure of human conditionally immortalized proximal tubule epithelial cells to indoxyl sulfate (IS) and a mixture of anionic PBUTs (UT mix) increased expression levels of NLRP3, caspase-1 and IL-1β, accompanied by a significant increase in IL-1β secretion and caspase-1 activity. Furthermore, IS and UT mix induced the production of intracellular reactive oxygen species, and caspase-1 activity and IL-1β secretion were reduced in the presence of antioxidant N-acetylcysteine. IS and UT mix also induced NF-κB activation as evidenced by p65 nuclear translocation and IL-1β production, which was counteracted by an IKK inhibitor. In vivo, using subtotal nephrectomy CKD rats, a significant increase in total plasma levels of IS and the PBUTs, kynurenic acid and hippuric acid, was found, as well as enhanced urinary malondialdehyde levels. CKD kidney tissue showed an increasing trend in expression of NLRP3 inflammasome components, and a decreasing trend in superoxide dismutase-1 levels. In conclusion, we showed that PBUTs induce inflammasome-mediated IL-1β production in proximal tubule cells via oxidative stress and NF-κB signaling, suggesting their involvement in disease-associated inflammatory processes.
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Affiliation(s)
- Milos Mihajlovic
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands; (M.M.); (Y.Y.); (S.A.); (V.L.); (D.A.)
| | - Merle M. Krebber
- Department Nephrology and Hypertension, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; (M.M.K.); (M.C.V.)
| | - Yi Yang
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands; (M.M.); (Y.Y.); (S.A.); (V.L.); (D.A.)
| | - Sabbir Ahmed
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands; (M.M.); (Y.Y.); (S.A.); (V.L.); (D.A.)
| | - Valeria Lozovanu
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands; (M.M.); (Y.Y.); (S.A.); (V.L.); (D.A.)
| | - Daria Andreeva
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands; (M.M.); (Y.Y.); (S.A.); (V.L.); (D.A.)
| | - Marianne C. Verhaar
- Department Nephrology and Hypertension, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands; (M.M.K.); (M.C.V.)
| | - Rosalinde Masereeuw
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands; (M.M.); (Y.Y.); (S.A.); (V.L.); (D.A.)
- Correspondence:
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