Progression of Increased Oxidative Stress and Inflammation in Chronic Kidney Disease Patients with Type 2 Diabetes Mellitus

Abstract

Type 2 diabetes mellitus (T2DM) patients have increased oxidative stress, inflammation and reduced antioxidant defenses mechanisms in the circulatory system. This study demonstrates the progression and correlation of oxidative stress and inflammation with chronic kidney disease (CKD), pre-hemodialysis and hemodialysis in T2DM patients. A total of 292 T2DM patients participated in the present study. These T2DM patients’ diagnoses ranged from stage 1 to 5 according to their estimated glomerular filtration rate (eGFR). Serum levels of high-sensitive C-reactive protein (hs-CRP) and malondialdehyde (MDA) were significantly increased, but total antioxidant capacity (TAC) in these T2DM patients was decreased. The eGFR was inversely correlated with MDA, hs-CRP, NAG, TG/HDL-C and positively correlated with HDL-C and TAC. Hs-CRP and TG/HDL-C were positively correlated with MDA, and negatively correlated with TAC and HDL-C in the present study. Multiple forward stepwise linear regression analyses demonstrated independent predictors of eGFR were hs-CRP ( = -0.572, r2 =0.425, p 0.001), Glu ( = -0.162, r2 =0.458, p 0.001), MDA ( = -0.111, r2 =0.479, p= 0.02) and TG/HDL-C ratio ( = -0.099, r2 =0.486, p= 0.04). The CKD progression, as demonstrated by increase in BUN, CT and decreased eGFR, was concomitant with increased MDA, hs-CRP levels and TG/HDL-C ratio in each group, but slightly declined in the patients receiving hemodialysis. eGFR reduction was parallel with the increased of oxidative stress and inflammation when CKD developed and progressed. Conclusions: oxidative stress and infla