Imperial College London
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ProfessorFrankKelly

Faculty of Medicine, School of Public Health

Battcock Chair in Community Health and Policy
 
 
 
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Contact

 

+44 (0)20 7594 8098 ext 48098frank.kelly Website

 
 
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Location

 

Sir Michael Uren HubWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Zitouni:2020:10.1016/j.freeradbiomed.2020.10.005,
author = {Zitouni, K and Steyn, MRCP and Lyka, E and Kelly, FJ and Cook, P and Ster, IC and Earle, KA},
doi = {10.1016/j.freeradbiomed.2020.10.005},
journal = {Free Radical Biology and Medicine},
pages = {283--289},
title = {Derepression of glomerular filtration, renal blood flow and antioxidant defence in patients with type 2 diabetes at high-risk of cardiorenal disease},
url = {http://dx.doi.org/10.1016/j.freeradbiomed.2020.10.005},
volume = {161},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundThe role of antioxidant status on microvascular blood flow and glomerular filtration (eGFR) in patients with type 2 diabetes and hypertension whose risk of progressive renal disease varies by ethnicity is unknown.MethodsAdult, non-Caucasian (n = 101) and Caucasian (n = 69) patients with type 2 diabetes, hypertension and/or microalbuminuria and an eGFR > 45 mL/min/1.73 m2 were randomised to receive 400 IU vitamin E and/or 20 μg selenium daily or matching placebo. eGFR (CKD-EPI) was measured at baseline, 3,6 and 12 months and renal blood flow by contrast-enhanced ultrasonography in a sub-group (n = 9) at baseline and 3 months by assessing the area under the time intensity curve (TIC). Circulating glutathione peroxidase 3 (GPx-3) activity was measured as a biomarker of oxidative defence status.ResultsThe time to change in eGFR was shortest with combined vitamin E and selenium than usual care (5.6 [4.0–7.0] vs 8.9 [6.8–10.9 months]; p = 0.006). Area under the TIC was reduced compared to baseline (38.52 [22.41–90.49] vs 123 [86.98–367.03]dB.s; P ≤ 0.05 and 347 [175.88–654.92] vs 928.03 [448.45–1683]dB.s; P ≤ 0.05, respectively] at 3 months suggesting an increase in rate of perfusion. The proportional change in eGFR at 12 months was greater in the group whose GPx-3 activity was above, compared with those below the cohort median (360 U/L) in the non-Caucasian and the Caucasian groups (19.1(12.5–25.7] % vs 6.5[-3.5 to 16.5] % and 12.8 [0.7 to 24] % vs 0.2 [-6.1 to 6.5] %).ConclusionIn these patients with type 2 diabetes and early CKD, antioxidant treatment derepresses renal blood flow and a rise in eGFR correlated directly with GPx-3 activity.SignificanceDiabetes mellitus is the world's leading cause of end-stage renal disease which has a predilection for black and minor ethnic groups compared with Caucasians. The differences in risk despite the benefits of conventional care may be related to oxidative stress.
AU  - Zitouni,K
AU  - Steyn,MRCP
AU  - Lyka,E
AU  - Kelly,FJ
AU  - Cook,P
AU  - Ster,IC
AU  - Earle,KA
DO  - 10.1016/j.freeradbiomed.2020.10.005
EP  - 289
PY  - 2020///
SN  - 0891-5849
SP  - 283
TI  - Derepression of glomerular filtration, renal blood flow and antioxidant defence in patients with type 2 diabetes at high-risk of cardiorenal disease
T2  - Free Radical Biology and Medicine
UR  - http://dx.doi.org/10.1016/j.freeradbiomed.2020.10.005
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000598060200004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
UR  - https://www.sciencedirect.com/science/article/pii/S0891584920312788
VL  - 161
ER  -
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