ALPHA-TOCOPHEROL (VITAMINE) FOR CONDITIONS ASSOC W/ CHRONIC RENAL INSUFFICIENCY

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。慢性肾脏疾病（CKD）与心脏病的高患病率有关，这是由于动脉狭窄的结果，这一过程被称为动脉粥样硬化。这种疾病的过程与血液中潜在有害物质的产生增加有关，统称为“氧化应激”。我们的假设是，抗氧化疗法，如维生素E，可以在透析开始前就起到减轻氧化应激的作用，这种氧化应激是肾衰竭的特征，具有改善或至少减缓这种疾病进程的潜力。我们研究的干预措施是一个为期3个月的抗氧化治疗疗程，每天服用800国际单位的维生素E。研究对象为35例正常对照和35例晚期慢性肾脏疾病（非糖尿病）患者。这不是一个随机试验，也没有使用安慰剂对照。结果是1)氧化应激标志物水平的变化（主要结果），2)内皮功能和血液中的晚期糖基化（次要结果）。尿液也将在基线和研究结束时进行测试，以测量氧化应激标志物、晚期糖基化标志物、足细胞（肾脏中的一种细胞）损伤标志物和常规化学物质。根据这项研究的结果，我们将得出关于维生素E治疗慢性肾脏疾病的潜在作用的结论，特别是在透析治疗开始之前。这可能会对该患者群体的未来临床试验产生影响。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Chronic kidney disease (CKD) is associated with a high prevalence of heart disease as a result of narrowing of arteries, a process called atherosclerosis. This disease process is associated with increased production of potentially harmful substances in the blood collectively termed "oxidative stress." It is our hypothesis that antioxidant therapy such as vitamin E may serve to attenuate the oxidative stress that characterizes kidney failure even before the start of dialysis with the potential of ameliorating or at least slowing the progression of this disease process. The intervention that we aim to study is a 3-month course of antioxidant treatment with vitamin E in a dose of 800 IU per day. The groups of patients to be studied are 35 normal controls and 35 patients with advanced chronic kidney disease (non-diabetic). It is not a randomized trial and no placebo control is being used. The outcomes are 1) change in levels of markers of oxidative stress (primary outcome), 2) endothelial function and advanced glycation in the blood (secondary outcomes). Urine will also be tested both at baseline and at end of study to measure markers of oxidative stress, advanced glycation, markers of podocyte (a type of cell in the kidney) injury and routine chemistries. From the results of this study we will draw conclusions regarding the potential role of vitamin E treatment chronic kidney disease, especially before the initiation of dialysis therapy. This may have a bearing on future clinical trials in this patient population.