SMALL ANTIOXIDANT MOLECULES AND THEIR IMPORTANCE IN ACUTE KIDNEY INJURY

Munilakshmi U., Dr. Shashidhar K. N.*, Dr. Muninarayana C., Dr. Madhavi Reddy and Dr. Lakshmaiah V.

ABSTRACT

Background: Diabetes is a risk factor for developing Acute Kidney Injury (AKI) in which oxidative stress and inflammation are characteristic features. Methods: Case control prospective study. Subjects were categorized into two groups; Group I: Type 2 Diabetes Mellitus (T2DM) without AKI and Group II: T2DM with AKI. Group II further sub classified into five groups based on Risk, Injury, Failure, Loss and End stage (RIFLE) criteria. Parameters estimated were serum NGAL (Neutrophil Gelatinase Associated Lipocalin) by ELISA (Biovendor, USA), Serum creatinine (Scr), Uric Acid (UA), high sensitive C - reactive protein (hs-CRP), Nitric oxide (NO), Malondialdehyde (MDA), vitamin C and Glutathione peroxidase (GPx) by Spectrophotometric assays. eGFR calculated by Modification of Diet in Renal Disease (MDRD) equation. Results: In Group II NGAL, Scr, MDA, NO, hs-CRP and UA showed a significant elevation while eGFR, Vitamin C, and GPx concentrations were statistically significant in Group I. In Group II as per RIFLE classification NGAL, Scr and NO were significantly elevated in all the subgroups. Conclusion: An imbalance between oxidants and antioxidants were seen in both Groups I and II. So estimation of these parameters in early stages may reduce morbidity rate and prevent risk of AKI in T2DM. In addition to a clinical examination, estimation of MDA and Vitamin C can serve as supportive biochemical markers for early diagnosis and therapeutic intervention.

Keywords: Acute kidney Injury, RIFLE, Malondialdehyde, Nitric oxide, hs-CRP.