Reducing the Risk of Stroke in Patients with Impaired Renal Function: Nutritional Issues.
J Stroke Cerebrovasc Dis
; 30(9): 105376, 2021 Sep.
Article
en En
| MEDLINE
| ID: mdl-33214054
ABSTRACT
Patients with renal failure have extremely high cardiovascular risk; in dialysis patients the risk of stroke is increased approximately 10-fold over that in the general population. Reasons include not only a high prevalence of traditional risk factors such as diabetes, hypertension and dyslipidemia, but also the accumulation of toxic substances that are eliminated by the kidneys, so have very high levels in patients with renal failure. These include plasma total homocysteine, asymmetric dimethylarginine, thiocyanate, and toxic products of the intestinal microbiome (Gut-Derived Uremic Toxins; GDUT), which include trimethylamine N- oxide (TMAO), produced from phosphatidylcholine (largely from egg yolk) and carnitine (largely from red meat). Other GDUT are produced from amino acids, largely from meat consumption. Deficiency of vitamin B12 is very common, raises plasma tHcy, and is easily treated. However, cyanocobalamin is toxic in patients with renal failure. To reduce the risk of stroke in renal failure it is important to limit the intake of meat, avoid egg yolk, and use methylcobalamin instead of cyanocobalamin, in addition to folic acid.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Vitamina B 12
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Deficiencia de Vitamina B 12
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Estado Nutricional
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Suplementos Dietéticos
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Accidente Cerebrovascular
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Dieta
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Insuficiencia Renal
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Riñón
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
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Risk_factors_studies
Límite:
Humans
Idioma:
En
Año:
2021
Tipo del documento:
Article