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

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。慢性肾脏疾病(CKD)与由于动脉狭窄而导致的心脏病的高发病率有关，这一过程称为动脉粥样硬化。这一疾病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，抗氧化剂治疗，如维生素E，可能有助于减轻氧化应激，甚至在开始透析之前就表现为肾衰竭的特征，有可能改善或至少减缓这一疾病过程的进展。我们旨在研究的干预措施是一个为期3个月的抗氧化剂疗程，每天服用800IU的维生素E。被研究的患者组为35名正常对照组和35名晚期慢性肾病(非糖尿病)患者。这不是一项随机试验，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)血管内皮细胞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、晚期糖基化、足细胞(肾脏中的一种细胞)损伤的标记和常规化学指标。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，特别是在开始透析治疗之前。这可能会对未来在这一患者群体中进行的临床试验产生影响。

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.