Anemia is a major health condition associated with chronic kidney disease (CKD). A key underlying cause of this disorder is iron deficiency. Although intravenous iron treatment can be beneficial in correcting CKD-associated anemia, surplus iron can be detrimental and cause complications. Excessive generation of reactive oxygen species (ROS), particularly by mitochondria, leads to tissue oxidation and damage to DNA, proteins, and lipids. Oxidative stress increase in CKD has been further implicated in the pathogenesis of vascular calcification. Iron supplementation leads to the availability of excess free iron that is toxic and generates ROS that is linked, in turn, to inflammation, endothelial dysfunction, and cardiovascular disease. Histidine is indispensable to uremic patients because of the tendency toward negative plasma histidine levels. Histidine-deficient diets predispose healthy subjects to anemia and accentuate anemia in chronic uremic patients. Histidine is essential in globin synthesis and erythropoiesis and has also been implicated in the enhancement of iron absorption from human diets. Studies have found that L-histidine exhibits antioxidant capabilities, such as scavenging free radicals and chelating divalent metal ions, hence the advocacy for its use in improving oxidative stress in CKD. The current review advances and discusses evidence for iron-induced toxicity in CKD and the mechanisms by which histidine exerts cytoprotective functions.

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A quasi-experimental study with static-group comparison was done between (insert the interval of study) to identify the effect of back rolling massage with green coconut oil extract towards breastmilk production on postpartum mothers. The intervention group was the mothers that were given back rolling massage with virgin coconut oil (VCO). The control group was postpartum mothers that were given back rolling massage without green coconut oil extract. The 24 samples that were used for this study consisted of 2 sample groups; 12 samples in the intervention group and 12 samples in the control group. The average breastmilk production of the group with VCO extract in day 4 is 46.9 mL while the group without VCO extract is 42.9 mL until it shows no significant difference towards breastmilk production on day 4 with p-value = 0.794. On day 7 shows that the VCO extract group has breastmilk production 87.3 mL compared to the group without VCO only 49.2 mL until there is a significant difference with p-value = 0.046. The antioxidant analysis shows that VCO extract contained alkaloids and saponin. Back rolling massage with green coconut oil extract is effective in increasing breastmilk production at day 7. HIGHLIGHTS Alkaloid and Saponim in VCO can give benefits if applied as topical oil for therapy of back rolling massage Breast milk production increased significantly in respondents who were massaged using VCO compared to non-VCO Back rolling massage with green coconut oil extract is effective in increasing breastmilk production at day 7