Access Type

Open Access Dissertation

Date of Award

January 2017

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Nutrition and Food Science

First Advisor

Kai-Lin Catherine Jen

Abstract

The purpose of this study was to understand the relationship between dietary intake of antioxidants and omega-3 fatty acids on free radical injury and free radical scavenging in children with chronic kidney disease (CKD) so that complications of kidney failure, especially cardiovascular disease, may be avoided or delayed. Children with CKD on dialysis and post-renal transplantation are at an extremely high risk for cardiovascular morbidity and mortality. We hypothesized that children with CKD who have higher dietary intake of antioxidants and omega-3 FAs, would have lower free radical injury, as measured by 8-Isoprostanes (8-ISOP) and Thiobarbituric Acid Reactive Substances (TBARS) and higher free radical scavenging, as measured by ABTS (2,2’-Azino-di-[3-ethylbenzthiazoline sulphonate]) compared to children with CKD with lower intakes of these nutrients. Pre-dialysis was the baseline comparative group for this study. Nutrient intake was assessed by means of a 24-hour diet recall obtained prior to a routine blood draw and the child or parents/caregivers were asked to complete and return 3-day dietary records by mail. Nutrient intakes were analyzed using the software Food Processor® Nutrition Analysis by EHSA. Forty-seven children with CKD, 3 to 21 years of age, 72.3% males were enrolled from the Detroit Medical Center (DMC) - Children’s Hospital of Michigan (CHM) Specialty Center. The results showed that high blood lipid levels were correlated with oxidative stress biomarkers. Antioxidant intake was not correlated with oxidative stress, however antioxidant intake with omega-3 FAs increased blood hemoglobin and ferritin levels that may vary with free radical injury and free radical scavenging biomarkers. High cholesterol intake reduced ABTS levels. Children on dialysis with higher intake of antioxidants with omega-3 FAs had better dialysis outcome (Kt/V) and control of SBP. High triglyceride levels were shown to impair renal function and may affect bone health. Clinical implications include counseling by a renal dietitian about foods high in antioxidants, omega-3 FAs, and calcium to lower blood pressure, improve blood lipid levels and renal function, and indirectly reduce oxidative stress.

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