Association of Oxidative Stress With Biochemical Markers in Diabetic and Non-diabetic Chronic Kidney Disease Patients: A Cross-Sectional Study

TL;DR

This study finds that diabetic kidney disease patients have higher oxidative stress levels, which worsen with disease progression, suggesting oxidative stress could help predict and manage chronic kidney disease.

Contribution

The study identifies oxidative stress markers, particularly MDA, as potential prognostic indicators in diabetic versus non-diabetic CKD.

Findings

Diabetic CKD patients had significantly higher oxidative stress markers and worse kidney function compared to non-diabetic CKD patients.

Malondialdehyde levels correlated positively with CKD severity and negatively with estimated glomerular filtration rate.

Oxidative stress is suggested as a potential therapeutic target and prognostic biomarker in CKD.

Abstract

Background

Chronic kidney disease (CKD) is exacerbated by oxidative stress (OS), which accelerates renal injury and cardiovascular complications. Diabetes intensifies OS via hyperglycemia and mitochondrial dysfunction, promoting faster decline in diabetic kidney disease (DKD). This study compares OS markers with standard biochemical parameters in diabetic versus non-diabetic CKD to inform risk stratification and management.

Methods

This hospital-based, cross-sectional study enrolled 240 CKD patients (108 diabetic, 132 non-diabetic) over one year. Demographics, clinical data, and biochemical parameters-including fasting/postprandial blood sugar (FBS/PPBS), HbA1c, creatinine, urea, uric acid, estimated glomerular filtration rate (eGFR), and malondialdehyde (MDA)-were collected. Group comparisons, ANOVA, post-hoc Tukey, and Pearson's correlation assessed associations, with p<0.05 considered significant.

Results

A total of 240 patients with chronic kidney disease were included in the study, of whom 108 (45.0%) had DKD and 132 (55.0%) had non-DKD. Most patients, 135 (56.2%), were aged 40-59 years. Regarding sex distribution, 163 (67.9%) were male, and 77 (32.1%) were female. Stage 5 CKD was the most prevalent, observed in 142 (59.2%) patients. Patients with DKD demonstrated significantly higher FBS, PPBS, HbA1c, uric acid, and MDA, with lower eGFR compared to non-DKD (p<0.05). MDA levels showed a positive correlation with blood urea, serum creatinine, uric acid, and CKD stage, and a negative correlation with eGFR (p<0.05).

Conclusion

Diabetic CKD patients exhibit a higher oxidative burden than non-diabetic CKD patients, and MDA levels rise progressively with worsening CKD stage. These results emphasize the clinical relevance of oxidative stress in renal dysfunction and suggest its potential role as a prognostic biomarker and therapeutic target in CKD.