The effect of dietary antioxidant capacity on oxidative stress index, inflammation and uremic itching in hemodialysis patients

It was planned to determine the relationship between dietary antioxidant capacity and serum oxidative stress index, inflammatory parameters and uremic pruritus in hemodialysis patients with end-stage renal disease. This is a case-control study conducted with 82 individuals. The study was conducted with 41 patients receiving hemodialysis treatment in Malatya Training and Research Hospital Hemodialysis Unit and 41 healthy individuals who came to the internal medicine outpatient clinic for routine check-up. Information about the demographic characteristics, health status and diseases of the individuals were obtained by the researcher by face-to-face interview method. Anthropometric measurements of individuals [(body weight (kg), height (cm), waist circumference (cm), hip circumference (cm), upper middle arm circumference (MUAC) (cm) and triceps skinfold thickness (TSF) (cm)] made by the researcher. In addition, Subjective Global Assessment (SGD) and 5-D İtch Scale were applied and a physical activity registration form was filled to determine physical activity status. Food consumption status of individuals was evaluated using 3-day food consumption record and dietary antioxidant capacity was determined by oxygen radical absorbance capacity (ORAC) method. Some biochemical findings were recorded from routine analyzes, serum total oxidant level (TOS) and total antioxidant level (T-AOC) parameters were analyzed, and serum oxidative stress index (sOSI) was calculated. The mean age of the hemodialysis patients (54.8±12.60 years) and the control group (53.9±11.77 years) who participated in the study were found to be similar (p>0.05). Body mass index (BMI), hip circumference, TSF and MUAC measurements of male patients receiving hemodialysis treatment were found to be lower than male subjects in the control group (p<0.05). A statistically significant difference was found between TSF of female patients receiving hemodialysis treatment and female individuals in the control group (p<0.05). In hemodialysis patients, sOSI value decreased significantly before and after dialysis compared to ORAC level (p<0.05). In the control group, the increase in T-AOC and the decrease in TOS and sOSI were found to be significant compared to the ORAC level (p<0.05). Daily energy intake of hemodialysis patients (kcal), vegetable protein (g), percentage of energy from protein, carbohydrate (g), fat (g), polyunsaturated fatty acid (PUFA) percentage, fiber (g), soluble fiber (g), insoluble fiber (g), vitamin C (mg), vitamin E (mg), thiamine (mg), riboflavin (mg), niacin (mg), vitamin B6 (mg), vitamin B12 (mcg), folic acid (mcg) and potassium (mg) levels and dietary total antioxidant capacity (dTAC) were found to be lower than the control group (p<0.05). While 53.7% of the patients receiving hemodialysis treatment had very light activity levels, 51.2% of the individuals in the control group had heavy activity levels (p<0.05). A positive and significant relationship was found between the education, physical activity and dTAC of the patients receiving hemodialysis treatment (p<0.05, r=0.375, r=0.627). It was observed that there was no significant relationship between the itch score of the individuals and the biochemical findings and nutrients (p<0.05). Anthropometric measurements and BMI were found to have a negative relationship with dTAC (p=0.007). Serum albumin, high density lipoprotein cholesterol (HDL-C) and neutrophil/lymphocyte ratio were found to have a significant positive relationship with dTAC. There is a positive relationship between dTAC and dietary protein (kg/avg), beta carotene (mcg/day), vitamin C (mg/day), vitamin E (mg/day), PUFA (g/day) ( p=0.002). As a result, the energy, protein and dietary total antioxidant capacity of the hemodialysis patients were found to be significantly lower than the control group. Hemodialysis patients should be supported in terms of physical activity, and dTAC content should be increased by providing a nutritional variety suitable for the diet. Key Words: Dietary Total Antioxidant Capacity, Hemodialysis, Itch, Serum Oxidative Stress Index