Effects of Bioactive Dietary Components on Changes in Lipid and Liver Parameters in Women after Bariatric Surgery and Procedures.

Excess adipose tissue, as well as its distribution, correlates strongly with disorders of lipid and liver parameters and chronic inflammation. The pathophysiology of metabolic diseases caused by obesity is associated with the dysfunction of visceral adipose tissue. Effective and alternative interventions such as the Bioenteric Intragastric Balloon and bariatric surgeries such as the Roux-en-Y gastric bypass. The aim of this study was to assess the effect of modifying the recommended standard weight loss diet after bariatric surgery and procedures on reducing chronic inflammation in overweight patients. In the study, bioactive anti-inflammatory dietary components were used supportively. Changes in the concentrations of lipid parameters, liver parameters, antioxidant enzymes, cytokines, and chemokines were demonstrated. The enrichment of the diet, after bariatric surgery, with the addition of n-3 EFAs(Essential Fatty Acids), bioflavonoids, vitamins, and synbiotics resulted in higher weight losses in the patients in the study with a simultaneous reduction in parameters indicating liver dysfunction.

Long-Term Consequences of Increased Activity of Urine Enzymes After Cardiac Surgery - A Prospective Observational Study.

Introduction: Cardiac surgery associated AKI (CSA-AKI) complicates recovery and may be associated with a greater risk of developing chronic kidney disease and mortality. The aim of this study was to assess long-term clinical consequences of transient increased activity of urinary enzymes after cardiac surgery (CS). Methods: An observational study was conducted in a group of 88 adult patients undergoing planned coronary artery bypass grafting (CABG), but all samples were obtained from 79 patients. The activity of urinary enzymes: N-acetyl-beta-glucosaminidase (NAG), arylsulfatase A (ASA) and beta-glucuronidase was evaluated in sequential urine samples. A comparative analysis of biochemical parameters was performed regarding the occurrence of acute kidney injury (AKI) defined by KIDGO at 24 hours, at day 30 and 5-years after the operation. Results: During the first 24 hours after CS AKI was diagnosed in 13 patients. A comparison of the activity of urinary enzymes in pre-defined time-points showed significant differences for ASA and NAG (post OP-sample p < 0.028 and p < 0.022; POD 1 sample p < 0.004 and p < 0.001 respectively). No patient had any biochemical or clinical features of kidney failure at day 30. In the AKI group kidney failure was diagnosed in 36% of patients within 5 years of follow-up as opposed to 5% in the no AKI group. The activities of tubular enzymes in urine reflect a general injury of kidney tubules during and after the operation. However, they are not ideal biomarkers for prediction of the degree of kidney injury and further poor prognosis of CS-AKI.

Effect of Diet and Supplementation on Serum Vitamin C Concentration and Antioxidant Activity in Dialysis Patients.

Loss of vitamin C, especially in conjunction with an inadequate supply, can lead to decreased plasma concentrations of vitamin C. This in turn can lead to overt or subclinical deficiency. The present study aimed to evaluate the effects of diet and supplementation on vitamin C concentrations and serum antioxidant activity (FRAP) in hemodialysis (HD) patients. Sixty-eight HD patients participated in the study. In all of them, the diet was initially determined, and they were divided into five groups according to the diet and supplementation used. Group 1 received an unchanged diet, considered by them to be optimal; in group 2, the standard diet used in HD patients was introduced; in group 3, a standard diet enriched with natural antioxidants was employed; in group 4, a standard diet as in group 2 was used, but enriched with supplements (vitamin C, vitamin E, Se, and Zn). In contrast, group 5 consisted of HD patients with coexisting diabetes. Vitamin C serum levels were determined by high-performance liquid chromatography HPLC and antioxidant activity by The Ferric Reducing Ability of Plasma FRAP. The study shows that a well-chosen diet can slow the build-up of malnutrition and increase antioxidant activity as measured by the FRAP method in the blood of hemodialysis patients. Vitamin C supplementation can improve antioxidant status in hemodialysis patients. * The results presented in this paper complement our study, which assessed the effect of diet on the activity of erythrocyte antioxidant enzymes: Catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px), but also on the concentrations of non-enzymatic antioxidants (tocopherols, carotenoids, and vitamin C) in hemodialysis patients. In the study, plasma malondialdehyde (MDA) concentrations were assessed as an indicator of oxidative damage.

Iron excretion in urine in patients with acute kidney injury after cardiac surgery.

BACKGROUND: Hemolysis during cardiopulmonary bypass may lead to acute kidney injury caused by an excessive amount of iron. The clinical usefulness of the measurement of total iron concentration in the urine with the use of the atomic absorption spectrometry method for early identification of patients with postoperative acute kidney injury is not well-established. OBJECTIVES: An observational, prospective study was conducted on a group of 88 pre-selected adult patients undergoing a planned coronary artery bypass grafting (CABG) procedure. MATERIAL AND METHODS: The amount and concentrations of total iron, creatinine and neutrophil gelatinaseassociated lipocalin (NGAL) were evaluated in urine samples. A comparative analysis of the evaluated biochemical parameters was performed in regard to the occurrence of acute kidney injury 48 h postoperatively. RESULTS: Patients in the acute kidney injury group presented more advanced age (p = 0.01), preoperative myocardial infarction (p = 0.02), diuresis reduction (p = 0.04), and lower total iron levels in the 48-hour urine sample (p = 0.01). There was no difference when considering iron concentration in single urine samples in the study group. CONCLUSIONS: The sole result of total iron concentration in single urine samples is unreliable for the diagnosis of acute kidney injury after cardiac surgery. Decreased excretion of iron in the urine seems to be an important additional element in the multifactorial pathogenesis of acute postoperative kidney failure.

Cardiac surgery related cardio-renal syndrome assessed by conventional and novel biomarkers - under or overestimated diagnosis?

INTRODUCTION: Serum creatinine is a 'gold standard' criterion of recognizing and staging of acute kidney injury (AKI) despite it being a suboptimal, delayed indicator. The interpretation of increased values of biomarkers imposes great difficulty regarding cardiac surgery procedures performed with cardiopulmonary bypass and may lead to under- or overestimated diagnosis. The aim of this study was to evaluate the clinical utility of the sole serum creatinine or urine neutrophil gelatinase-associated lipocalin (NGAL) concentration used for identification of patients with AKI after cardiac surgery. MATERIAL AND METHODS: A prospective observational study was conducted on a group of 88 adult patients undergoing a coronary artery bypass grafting procedure. Serum creatinine was evaluated on the day of the operation, and 24 and 48 h post-operatively. Urinary NGAL concentration was measured: immediately after and one hour after cardiopulmonary bypass, and 24 h from the beginning of the operation. We assessed features of kidney injury and 30-day and 5-year mortality. RESULTS: Patients in the AKI group diagnosed with creatinine level and urine output criteria presented more advanced age (p = 0.01), higher body mass index (p = 0.01) and preoperative myocardial infarction (p = 0.02). Elevation of NGAL level was observed in 5 of 13 cases with AKI, based on creatinine criteria and 4 of 75 cases without AKI. Within 5 years after the surgical procedure the recurrence of renal failure was 36% in the AKI group (with perioperative NGAL elevation in 2 cases only). CONCLUSIONS: In the cardiac surgery patients the diagnosis of AKI based on sole serum creatinine or urine NGAL concentration confirmed transient kidney injury. However, the clinical implications of these findings are insufficient for prediction of clinical outcome.