Mediterranean diet improves dyslipidemia and biomarkers in chronic renal failure patients

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Abstract
Dyslipidemia, oxidative stress (OS) and inflammation increase the risk of cardiovascular disease in chronic renal failure (CRF) patients. The aim of this study was to evaluate the effect of nutritional advice on dyslipidemia and biomarkers in CRF patients. 40 CRF patients with dyslipidemia, hypertriglyceridemia and/or hypercholesterolemia were randomly assigned to either the control or the intervention group. The intervention group received nutritional advice adapted to a Mediterranean diet (MD). Patients were assessed at baseline (T0) and after 30 (T1), 60 (T2) and 90 (T3) days for dietary intake and biomarkers. In the intervention group compared to the control group, TG concentrations were decreased by 26% at T3 (p < 0.05), TC concentrations were diminished by 14% at T2 and by 35% at T3 (p < 0.05). A decrease in LDL-C was noted at T2 and T3 (p < 0.05). The TC/HDL-C ratio was diminished at T1, T2 and T3 (p < 0.05). The apo A-I/apo B ratio was elevated at T3 (p < 0.05). HDL-C, apo A-I, apo B concentrations and the TC/LDL-C ratio were similar in the both groups at T1, T2 and T3. Creatinine, urea, glomerular filtration rate (GFR), urate, iron and bilirubin values remained unchanged in both groups. Haemoglobin concentrations were elevated at T1 (p < 0.05). Increased albumin values were observed at T2 (p < 0.05). CRP concentrations were decreased by 29% at T1 (p < 0.05) and 40% (p < 0.01) at T3. Fibrinogen (p < 0.01) concentrations were decreased at T3. In the intervention group compared to control group (p < 0.01), TBARS values were decreased by 16% at T2 and 21% at T3 (p < 0.05). In this study, we demonstrate that the nutritional management of CRF patients before dialysis based on the MD improves food consumption, reduces dyslipidemia and protects against lipid peroxidation and inflammation, allowing patients to enter dialysis with an acceptable nutritional and cardiovascular state.

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