Search

Metabolic acidosis is a severe complication of chronic kidney disease (CKD) which is associated with nefarious impairments such as bone demineralization, muscle wasting, and hormonal alterations, for example, insulin resistance. Whilst it is possible to control this condition with alkali treatment, consisting in the oral administration of sodium citrate or sodium bicarbonate, this type of intervention is not free from side effects. On the contrary, opting for the implementation of a targeted dietetic-nutritional treatment for the control of CKD metabolic acidosis also comes with a range of additional benefits such as lipid profile control, increased vitamins, and antioxidants intake. In our review, we evaluated the main dietary-nutritional regimens useful to counteract metabolic acidosis, such as the Mediterranean diet, the alkaline diet, the low-protein diet, and the vegan low-protein diet, analyzing the potentialities and limits of every dietary-nutritional treatment. Literature data suggest that the Mediterranean and alkaline diets represent a valid nutritional approach in the prevention and correction of metabolic acidosis in CKD early stages, while the low-protein diet and the vegan low-protein diet are more effective in CKD advanced stages. In conclusion, we propose that tailored nutritional approaches should represent a valid therapeutic alternative to counteract metabolic acidosis.

Background and Aims Chronic degenerative non-communicable diseases represent one of the main causes of death in the world. Among these, chronic kidney disease (CKD) has an estimated prevalence of 7-12% worldwide. CKD is related to numerous comorbidities, especially these cardiovascular. Furthermore, its progression is characterized by a low-grade inflammatory status and oxidative stress, factors that negatively influence quality of life. In recent years, numerous in vitro and in vivo studies have analysed the beneficial effects of natural bioactive compounds on health. Extra virgin olive oil (EVOO) is rich in minor polar compounds (MPCs), capable of exerting a cardioprotective, anti-inflammatory and antioxidant action. The 98-99% of EVOO total weight is made up by fatty acids, in particular, monounsaturated ones such as oleic acid, and a small percentage 1-2% by MPCs. Among MPCs, hydroxytyrosol, tyrosol, oleacin and oleocanthal are of particular importance for their heathy effects. In our study, we analysed the potential healthy effects of EVOO MPCs in CKD patients. Method The EVOO selected for the study (Ophenoil), was previously characterized for its high content of MPCs through quantitative and qualitative analysis performed using HPLC-DAD-MS and Oxitester. We enrolled 20 CKD patients undergoing conservative therapy (stages I-IV according to K-DIGO guidelines). All enrolled patients have been instructed to assume 40 ml per day of EVOO, for 9 weeks. Laboratory parameters have been collected at two different time-points of the study (at baseline T0 and after 9 weeks T1) (Fig 1). At T0 the patients have been undergo to a detailed medical history. All CKD patients have been unstructured to follow a conventional Mediterranean diet (which adherence is assessed by PREDIMED questionnaire), containing a controlled protein intake according to CKD stage, in which the EVOO Ophenoil represent the main source of plant-based fats. In both time-points of the study, all patients have been undergoing to blood sampling to evaluate renal function, lipid profile, inflammatory parameters (C-reactive protein-CRP, erythrocyte sedimentation rate-ESR, Interleukin(IL)-6, Tumor necrosis factor(TNF)-α) and oxidative stress (Free Oxygen Radicals Test-FORT and Free Oxygen Radical Defence-FORD by CR4000). Moreover, we evaluated the cardiovascular risk indices (Carotid intima-Media Thickness (C-ITM) monitored by eco(color)Doppler ultrasound). Each patient has been interviewed with Quality of Life Assessment Questionnaire (Short-Form 36 items health Survey- SF-36) and International Physical Activity Questionnaire (IPAQ). Results Preliminary data highlight a reduction of the inflammatory state, monitored by CRP (p=0.0299), ESR (p=0.0063), TNF-α (p=0.0001), IL-6 (p=0.0219), an improvement of renal function (azotemia, p=0.0256) and of lipid profile (triglycerides, p=0.0476) after 9 weeks of EVOO assumption (Fig 2). Moreover, we observed a significant improvement of the C-ITM (p=0.0146) and a significant reduction of oxidative stress monitored by FORT (p=0.0144). The results of the PREDIMED and IPAQ questionnaires showed no significant differences. This data indicates that patients have not changed their lifestyle and the results obtained are attributable to EVOO assumption. At the end of the study, there was an improvement of quality of life, in the domains of emotional well-being (p=0.0340) and general health (p=0.0405) of SF-36 questionnaire (Fig 3). Conclusion The consumption of EVOO with high MPCs content would seem to exert an anti-inflammatory (due to high content of oleocanthal) and antioxidant (due to high content of hydroxytyrosol, oleacin and oleuropein aglicone) action in CKD patients. Therefore, once again it is highlighted how the diet therapy plays a pivotal role in the clinical management of CKD patients and that it allows an improvement of their quality of life.

Background and Aims Breath analysis techniques allow detection and quantification of multiple analytes present in breath to the low parts per billion volume (ppbv) level. One such technique is selected ion flow tube–mass spectrometry (SIFT-MS), which can measure numerous volatile organic compounds (VOCs) in breath on-line and in real-time. This technique has already been used in an innovative manner to monitor infectious, inflammatory status and metabolic conditions. However, there is no evidence on its use in ambulatory patients with chronic kidney disease (CKD). End-stage-renal-disease patients are characterized by "uremic halitosis" caused by the accumulation of uremic toxins that are detectable in breath such as ammonia and amines. The aims of this study are identifying a possible correlation between the detected VOCs and the presence of CKD, moreover, exploring the range of VOCs levels in patients with different CKD stage. Method In the present study, a mobile Voice200ultra® SIFT-MS instrument was made available by the Agilent SRA Division. The SIFT-MS allowed to quantify the VOCs in CKD patients. The SIFT-MS uses a precise and controlled application of “soft” chemical ionization. We enrolled 50 CKD patients, divided into two subgroups according to the estimated glomerular filtration rate (eGFR): eGFR ≥30 mL/min/1.73m2 (A) and eGFR Results Among all the VOCs analyzed, the most significant results are observed for ammonia and isoprene. In particular, the ROC curve of ammonia highlighted statistically significant differences between the three subgroups respectively A vs C AUC=0,756 p=0,001; B vs C AUC=0,942 p The ROC curve of isoprene showed statistically significant differences between the three subgroups respectively B vs C AUC=0,669 p=0,050; A vs B AUC=0,691 p=0,014 (Figure 2). These data allow us to define this a highly accurate test. The same significant results were observed also with Anova one-way test that highlighted an inversely correlation between the ammonia breath concentration and eGFR, and a direct correlation between isoprene and eGFR. Conclusion This preliminary data confirms the potential utility of SIFT-MS for the CKD diagnosis and the possible relation between the VOCs concentration and CKD stage. This exam could be a new, non-invasive, fast-performing diagnostic technique with real-time results useful for clinical management of CKD. The study was inserted in the projects: “MioMenù: nuova filiera dell’agro-industria e una cucina tracciata natura/benessere- Lazio Region” and “BioSynOL- Oil and Legumes: biodynamic and synergistic crops for naturally fortified foods and innovative products for health and sport – G.O.Tuscany Region”.

The Coronavirus Disease-19 (COVID-19) pandemic has caused more than 100,000,000 cases of coronavirus infection in the world in just a year, of which there were 2 million deaths. Its clinical picture is characterized by pulmonary involvement that culminates, in the most severe cases, in acute respiratory distress syndrome (ARDS). However, COVID-19 affects other organs and systems, including cardiovascular, urinary, gastrointestinal, and nervous systems. Currently, unique-drug therapy is not supported by international guidelines. In this context, it is important to resort to adjuvant therapies in combination with traditional pharmacological treatments. Among natural bioactive compounds, palmitoylethanolamide (PEA) seems to have potentially beneficial effects. In fact, the Food and Drug Administration (FDA) authorized an ongoing clinical trial with ultramicronized (um)-PEA as an add-on therapy in the treatment of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. In support of this hypothesis, in vitro and in vivo studies have highlighted the immunomodulatory, anti-inflammatory, neuroprotective and pain-relieving effects of PEA, especially in its um form. The purpose of this review is to highlight the potential use of um-PEA as an adjuvant treatment in SARS-CoV-2 infection.

Chronic kidney disease (CKD) is one of the most common chronic non-communicable degenerative diseases and it represents an important risk factor for cardiovascular morbidity and mortality. The Mediterranean diet, in which extra virgin olive oil (EVOO) is the main source of vegetal fats, represents a nutritional-diet regimen that is useful for the treatment of CKD and its comorbidities. We tested two different EVOOs, characterized by a high (Synergy) and medium (Luxolio) content of minor polar compounds (MPCs), detected by HPLC-DAD-MS analysis, in 40 nephropathic patients, at a dose of 40 mL/day for 9 weeks. We evaluated the effects of these two EVOOs on renal function, body composition, oxidative stress, and inflammatory state, after 9 weeks of EVOOs consumption (T1) and after 2 months of wash-out (T2). We observed an improvement of renal function biomarkers (estimated-glomerular filtration rate, albuminuria, azotemia, uric acid), lipid profile, oxidative stress, inflammatory parameters (erythrocyte sedimentation rate, C-reactive protein) and in body composition at T1. These healthy effects were greater and persisted over time after the wash-out period in Synergy patients. The high MPC EVOO content seems to exert an antioxidant and anti-inflammatory effect in nephropathic patients and these protective actions are maintained over time.

Metabolic syndrome (MetS) is a clinical manifestation characterized by a plethora of comorbidities, including hyperglycemia, abdominal obesity, arterial hypertension, and dyslipidemia. All MetS comorbidities participate to induce a low-grade inflammation state and oxidative stress, typical of this syndrome. MetS is related to an increased risk of cardiovascular diseases and early death, with an important impact on health-care costs. For its clinic management a poly-pharmaceutical therapy is often required, but this can cause side effects and reduce the patient’s compliance. For this reason, finding a valid and alternative therapeutic strategy, natural and free of side effects, could represent a useful tool in the fight the MetS. In this context, the use of functional foods, and the assumption of natural bioactive compounds (NBCs), could exert beneficial effects on body weight, blood pressure and glucose metabolism control, on endothelial damage, on the improvement of lipid profile, on the inflammatory state, and on oxidative stress. This review focuses on the possible beneficial role of NBCs in the prevention and in the clinical management of MetS and its comorbidities.

Extra virgin olive oil (EVOO) is a lipid food, which constitutes a pillar of the Mediterranean diet. A high number of scientific data have demonstrated that it exerts a variety of beneficial effects on human health due to its peculiar chemical composition including fatty acids (98&ndash, 99%) and other active compounds even if found in a very low percentage (1&ndash, 2%). Among them, minor polar compounds (MCPs), represented mainly by phenolic compounds, are relevant for their healthy properties, as stated by the European Food Safety Authority&rsquo, s (EFSA) claims. In this paper, we described the results obtained from a pilot in vivo study, focused for the first time on the evaluation of the possible beneficial effects of two EVOOs on chronic kidney disease (CKD) patients after the consumption of 40 ml per day for 9 weeks. The selected EVOOs, traced in the production chain, and characterized by High-Performance Liquid Chromatography (HPLC-DAD-MS) analysis, resulted rich in MCPs and satisfied the EFSA&rsquo, s claim for their content of hydroxytyrosol and derivatives. The results obtained by this in vivo study appear to highlight the potential beneficial role in CKD patients of these EVOOs and are promising for future studies.

Background and Aims Urinary tract infections (UTIs) are estimated to account for over 7 million office visits per year. UTIs are about 50 times more frequent in women than in men, however, in men the incidence steeply increases after 50 years of age for prostate involvement. UTI diagnosis is based on symptoms and urinalysis. Antibiotic therapy is often required in subjects with relapsing UTIs. Therefore, it would be useful to develop a therapeutic strategy based on natural active compounds, free from side effects (such as on renal function), that could counteract UTIs recurrence. For this purpose, tannins (TNs) could represent a valid therapeutic alternative. TNs are polyphenolic compounds known for their anti-inflammatory, antimicrobial and antioxidant effects. Recent studies highlighted how TNs intake can counteract UTI recurrence, improving the quality of life. The aim of our study was to evaluate the beneficial action of chestnut TNs administered as oral food supplement (OFS) in recurrent UTI patients. Method OFS was characterized by HPLC/DAD/MS analysis for its content in secondary polyphenolic metabolites and by Folin-Ciocalteau in vitro tests for its antioxidative and anti-free radical activity with stable radical DPPH•. For in vivo tests, 16 chronic kidney disease (CKD) patients (8 female and 8 males) who suffered from recurrent UTIs, were recruited. The OFS was administered in 2 cps/ day, for 9 weeks. Patients were evaluated at T0= baseline and T1= after 9 weeks of OFS treatment. We performed laboratory and urinary tests, and the quality of life (SCL-90R questionnaire) and body composition (bioimpedentiometry) assessment. All parameters and questionnaires were evaluated at T0 and T1. At the same time, oxidative stress (OS) and antioxidant defenses were monitored using CR4000 (FORD and FORT tests). Results HPLC/DAD/MS quali-quantitative analysis allowed for an in depth chemical characterization of the individual polyphenols present in the OFS: total tannins amount is 10.542mg/g, whereas total anthocyanins are 1.885mg/g. The Folin Ciocalteu assay results show a total polyphenols content of 68.7mg/g GAE; the antiradical activity by DPPH assay is 94% for a solution 0.519mg/mL of powder. The epidemiological features of the population were reported in Table 1 and it was divided into two subgroups, according to gender. Laboratory parameters were reported in Table 2. During the study, we observed a drop out of three female subjects because of gastrointestinal (GI) disorders (nausea, gastric heartburn). We did not find any significative change in body composition parameters after OFS treatment. We highlighted a significant reduction (Table 3) of ESR only in male patients (16,7± 2,2 mm/h vs 11,3± 1,5 mm/h, p=0,0062). The urinalysis, showed a significant reduction of leukocytes in both subgroups (male: 43,5 (1-450) n/uL vs 15 ± 5,7 n/uL p = 0,0391; female: 28,5 (1-990) n/uL vs 7 (1-91) n/uL p= 0,0625) but urinary bacterial flora, after OFS supplementation significantly decreased only in male subjects (428 ± 143,4 n/uL vs 34 (0- 450) n/uL p= 0,0156). Interestingly we observed a significant reduction of OS parameters after OFS treatment as reported in Table 4. We also observed a reduction of the anxious and depressive components in male subjects in the SCL-90R questionnaire. Conclusion TNs seem to exert an antimicrobial action in a gender dependent manner, useful to counteract the recurrence of UTIs. OFS contains Serenoa repens, a substance with peripheral, antispastic and antiandrogenic action that could induce nausea and vomiting. Female patients dropped out for GI disorders had lower body weight and SR probably were overdosed for their body mass. In male subjects, the decrease in anxiety and depression at the end of the study, could be linked to the improvement of the urinary symptomatology. A randomized clinical trial conducted a larger population is needed to confirm these findings and explain the correlation with gender.