Kronik Böbrek Yetmezliğinde Antioksidan Vitaminlerin İnflamasyon ve Oksidatif Stres Üzerine Etkisi

Kronik böbrek yetmezliği (KBY), inflamasyonun ve oksidatif stresin sıklıkla eşlik ettiği bir süreç olarak bilinmektedir.Kronik böbrek yetmezliği hastalarında artan oksidatif stres düzeyleri, azalmış antioksidan savunma ve ortaya çıkankronik inflamasyon kardiyovasküler hastalıklar başta olmak üzere birçok sağlık sorunu için risk faktörü olabilmektedir.Bu nedenle hastalarda antioksidan tedavinin uygun kullanımı oldukça önem taşımaktadır. Antioksidan vitaminlerinsürece etkisi değerlendirildiğinde, KBY hastalarında retinol bağlayıcı protein katabolizmasındaki azalmalar nedeniyleserum A vitamini konsantrasyonlarının sıklıkla yüksek olduğu düşünülmektedir. Buna bağlı olarak KBY hastalarına ek Avitamini suplemantasyonu önerilmemektedir. Diğer bir antioksidan olan C vitamininin, prooksidan etki gösterebilme veoksalat oluşumunu artırma riski nedeniyle bu hastalara yönelik öneri konusu tartışmalıdır. Ancak diyaliz tedavisi alanhastalar değerlendirilirken C vitamininde gözlenen önemli kayıplar ve diyet kısıtlılıkları nedeniyle alımdaki azalmalardikkate alınmalıdır. Kronik böbrek yetmezliği hastalarında E vitamininin birçok olumlu etkisi bildirilmekle birliktesuplemantasyonun dozu, süresi ve uygulama yolu gibi farklılıklar nedeniyle net öneri vermek mümkün olmamaktadır.Bununla birlikte özellikle E vitamini kaplı diyaliz membran kullanımının oksidatif stresi azaltabileceği düşünülmektedir.Kronik böbrek yetmezliği hastalarında antioksidan vitamin desteğine yönelik çalışmaların devam etmesi gerekmeklebirlikte, hastaların diyet antioksidan vitamin alımlarının iyi değerlendirilmesi oldukça önem taşımaktadır.

Effects of Antioxidant Vitamines on Inflammation and Oxidative Stress in Chronic Kidney Disease

Chronic kidney disease (CKD) is often known as a process accompanied by inflammation and oxidative stress. Increasing oxidative stress levels, decreased antioxidant defense and chronic inflammation in CKD patients may be risk factors for many health problems, especially cardiovascular diseases. Therefore, proper use of antioxidant therapy is very important in these patients. When the effect of antioxidant vitamins is evaluated, serum vitamin A concentrations are often thought to be high in patients with CKD due to reductions in retinol-binding protein catabolism. Accordingly, vitamin A supplementation is not recommended for CKD patients. It is controversial to recommend vitamin C, another antioxidant, for these patients because of the pro-oxidant effects and risk of increasing oxalate formation. However, when evaluating patients receiving dialysis treatment, significant losses in vitamin C and decreases in intake due to dietary restrictions must be taken into attention. Although many positive effects of vitamin E have been reported in CKD patients, it is not possible to make clear recommendations due to differences such as the dosage, duration and route of supplementation. However, it is thought that the use of vitamin E-coated dialysis membrane can alleviate oxidative stress. In patients with CKD, studies on antioxidant vitamin supplements are needed. In addition, the dietary antioxidant vitamin intake of the patients is very important to evaluate.

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