Impact of Physical Activity and Natural Bioactive Compounds on Endothelial Dysfunction in Chronic Kidney Disease

Abstract

Chronic kidney disease (CKD) represents a world-wide public health problem. Inflammation, endothelial dysfunction (ED) and vascular calcifications are clinical features of CKD patients that increase cardiovascular (CV) mortality. CKD-related CV disease pathogenic mechanisms are not only associated with traditional factors such as arterial hypertension and dyslipidemia, but also with ED, oxidative stress and low-grade inflammation. The typical comorbidities of CKD contribute to reduce the performance and the levels of the physical activity in nephropathic patients compared to healthy subjects. Currently, the effective role of physical activity on ED is still debated, but the available few literature data suggest its positive contribution. Another possible adjuvant treatment of ED in CKD patients is represented by natural bioactive compounds (NBCs). Among these, minor polar compounds of extra virgin olive oil (hydroxytyrosol, tyrosol and oleocanthal), polyphenols, and vitamin D seem to exert a beneficial role on ED in CKD patients. The objective of the review is to evaluate the effectiveness of physical exercise protocols and/or NBCs on ED in CKD patients.

The Impact of Functional Bars and Adapted Physical Activity on Quality of Life in Chronic Kidney Disease: A Pilot Study

“…In this study, as already demonstrated in previous studies by our research group, the intake of products based on fruit, vegetables, EVOO, and natural extracts rich in antioxidant compounds belonging to the class of polyphenols, showed an improvement in the clinical status of CKD patients [20][21][22][23]25]. The obtained results confirm the positive effect of APA on body composition and on clinical status, alone or in synergy with functional bars, resulting in an adjuvant tool to counteract related-CKD comorbidities [11,82].…”

“…Among the natural bioactive compounds, polyphenols seem to play an important role in improving the state of health in chronic degenerative non-communicable diseases (CDNCDs) patients. Among these, CKD deserves a relevant mention, as described above [ 20 , 21 , 22 , 23 , 24 , 25 ].…”

Extra Virgin Olive Oil and Cardiovascular Protection in Chronic Kidney Disease

“…Among these comorbidities, special mention is due to alterations of calcium–phosphorus metabolism [ 4 , 5 ], hyperhomocysteinemia [ 6 , 7 ], the increase of asymmetric dimethylarginine (ADMA), malnutrition, uremic sarcopenia [ 8 , 9 ], the accumulation of toxic substances, including those derived from the gut microbiota [ 10 , 11 ], a low-grade chronic inflammatory state, and dyslipidaemia and metabolic acidosis [ 12 , 13 , 14 , 15 ]. All these factors contribute to the development of accelerated atherosclerosis in which the primum movens is represented by endothelial dysfunction (ED) [ 16 , 17 ]. Physiologically, the endothelium can be considered a “pervasive” organ that performs numerous functions, among which is the maintenance of vascular tone.…”

B-Cell Activating Factor Increases Related to Adiposity, Insulin Resistance, and Endothelial Dysfunction in Overweight and Obese Subjects

“…Though SCAT and VAT differ in their main metabolic characteristics, both are abundantly infiltrated with resident immune cells [ 6 ] that secrete pro-inflammatory cytokines such as TNF-α and IL-6, which actively promote adipocyte differentiation [ 7 ]. However, when maintained for long time, chronic low-grade inflammation has been described as one of the principal links between OB and its pathophysiological sequelae, such as insulin resistance (IR) [ 8 ], metabolic syndrome (MS) [ 9 ], endothelial dysfunction (ED) [ 10 ], type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD) [ 11 ].…”