Prospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Sep 25, 2024; 13(3): 95262
Published online Sep 25, 2024. doi: 10.5527/wjn.v13.i3.95262
Pilot study on the effect of flavonoids on arterial stiffness and oxidative stress in chronic kidney disease
Anastasia Vagopoulou, Panagiotis Theofilis, Despina Karasavvidou, Nasra Haddad, Dimitris Makridis, Stergios Tzimikas, Rigas Kalaitzidis
Anastasia Vagopoulou, Despina Karasavvidou, Nasra Haddad, Dimitris Makridis, Stergios Tzimikas, Nephrology Department “C. Katsinas”, General Hospital of Ptolemaida “Mpodosakeio”, Ptolemaida 50200, Greece
Panagiotis Theofilis, Rigas Kalaitzidis, Center for Nephrology “G. Papadakis”, General Hospital of Nikaia-Piraeus “Agios Panteleimon”, Nikaia-Piraeus 18454, Greece
Author contributions: Karasavvidou D conceived the study; Kalaitzidis RG supervised the study; Vagopoulou A, Karasavvidou D, Haddad N, Makridis D, and Tzimikas S contributed to the investigation; Vagopoulou A contributed to data curation and formal analysis; Vagopoulou A, Karasavvidou D, Haddad N, Makridis D, and Tzimikas S wrote the original draft; Theofilis P contributed to the visualization; Theofilis P and Kalaitzidis RG reviewed and edited the original draft; All authors read and approved the final manuscript.
Supported by the Greek Public Sector and the European Regional Development Fund, No. ΔΜΡ1-0010874 and No. MIS 5068931.
Institutional review board statement: The Ethics Committee of the General Hospital of Ptolemaida approved the study (80/18-11-2021).
Informed consent statement: All study participants, or their legal guardian, provided written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Data sharing statement: There are no additional data available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rigas Kalaitzidis, MD, PhD, Chief Physician, Director, Doctor, Center for Nephrology “G. Papadakis”, General Hospital of Nikaia-Piraeus “Agios Panteleimon”, Mantouvalou 3, Nikaia-Piraeus 18454, Greece. rigaska@gmail.com
Received: April 6, 2024
Revised: June 15, 2024
Accepted: June 26, 2024
Published online: September 25, 2024
Processing time: 165 Days and 20 Hours
Abstract
BACKGROUND

Flavonoids, the main class of polyphenols, exhibit antioxidant and antihypertensive properties.

AIM

To prospectively investigate the impact of flavonoids on arterial stiffness in patients with chronic kidney disease (CKD) stages I-IV.

METHODS

In this prospective, single-arm study, CKD patients with arterial hypertension and diabetes mellitus were enrolled. Baseline demographic, clinical, and laboratory variables were recorded. Patients received daily treatment with a phenol-rich dietary supplement for 3 months. Blood pressure, arterial stiffness (carotid-femoral pulse wave velocity, central pulse pressure), and oxidative stress markers (protein carbonyls, total phenolic compound, total antioxidant capacity) were measured at baseline and at study end.

RESULTS

Sixteen patients (mean age: 62.5 years, 87.5% male) completed the study. Following intervention, peripheral systolic blood pressure decreased significantly by 14 mmHg (P < 0.001). Carotid-femoral pulse wave velocity decreased from 8.9 m/s (baseline) to 8.2 m/s (study end) (P < 0.001), and central pulse pressure improved from 59 mmHg to 48 mmHg (P = 0.003). Flavonoids also reduced oxidative stress markers including protein carbonyls (P < 0.001), total phenolic compound (P = 0.001), and total antioxidant capacity (P = 0.013).

CONCLUSION

Flavonoid supplementation in CKD patients shows promise in improving blood pressure, arterial stiffness, and oxidative stress markers.

Keywords: Flavonoids; Chronic kidney disease; Arterial stiffness; Oxidative stress; Carotid-femoral pulse wave velocity

Core Tip: Daily flavonoid supplementation in patients with chronic kidney disease stage I-IV demonstrated significant reductions in peripheral systolic blood pressure, carotid-femoral pulse wave velocity, and central pulse pressure, along with improvements in oxidative stress markers. These findings suggest that flavonoids hold promise as an adjunctive therapy to manage hypertension, arterial stiffness, and oxidative stress in chronic kidney disease patients, potentially mitigating cardiovascular risk in this population.