The effect of combined melatonin therapy on indicators of oxidative status in chronic kidney disease developing in type 2 diabetes mellitus

Abstract

Chronic kidney disease (CKD) is the main cause of end-stage renal failure and is a complication of diabetes mellitus (DM). Oxidative stress plays the key role in its pathogenesis. In this regard, the use of drugs with antioxidant effect in DN therapy seems to be reasonable.Objective. In the course of this work, the effect of combination melatonin therapy on the biochemical parameters of the pathology development, concentration of pigment epithelial factor (PEDF) and the oxidative status of patients with CKD developing in type II diabetes was assessed.Material and methods. The study involved 60 people with CKD developing in type II diabetes. The patients were divided into 2 groups; each group included 30 people. The first group of patients underwent basic treatment; the second group of participants was given 2 mg of melatonin in addition to the basic therapy. The control group consisted of 65 apparently healthy individuals with normal indicators of general and biochemical blood tests. In the course of the work, the analysis of biochemical indicators of the pathology development, level of PEDF by enzyme immunoassay, the activity of free radical oxidation by the method of iron-induced biochemiluminescence (BCL) and the concentration of reduced glutathione (GSH) in the study participants was carried out.Results. The addition of melatonin to basic treatment led to a more signifi cant decrease in the intensity of free radical-induced oxidation and the level of PEDF, as well as an increase in the GSH content and general antioxidant eff ect in patients with CKD. The observed changes were accompanied by shifts in the indicators of proteinuria, hyperglycemia and urea concentration close to the ones detected in healthy volunteers group.Conclusion. The results obtained were, apparently, due to a more signifi cant decrease in the level of oxidative stress in patients who additionally received melatonin, which is characterized by the presence of antioxidant activity. An improvement in the oxidative status in patients of the second group was linked with the degree of changes in the clinical and biochemical parameters of pathology.