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Tuesday, 18 March 2014

Polycystic kidney disease in Foods' Points of View

By Kyle J. Norton

Polycystic kidney disease, also known as polycystic kidney syndrome is a cystic genetic disorder(a)(b)(c) of the kidneys, classified into:
A. Autosomal dominant polycystic kidney disease (ADPKD) affects all ethnic groups with a prevalence of 1:400-1:1000 live births. The disease induced formation of  numerous cysts in the kidneys with progressively expand and eventually destroy normal kidney structure and function. And may be associated to other disease complications(1)
B. Autosomal recessive polycystic kidney disease (ARPKD) is genetic disorder due to mutation of gene in chromosomal locus 6p12.2., causing up to 50% of affected neonates die of pulmonary hypoplasia and specific changes in the kidney and liver. Children who survive neonatal period (from birth to 28 days of age)may be experience with decrease in kidney size (not affect the kidney function) and change in echogenicity occurs, producing a pattern similar to patients with autosomal dominant polycystic kidney disease(2).
Although the disease is due to gene mutation, according to the study by the West Virginia University, certain phytochemicals in foods and herbs have found effectively in attenuation of cyst pathogenesis in animal studies(3).

1. Dietary Flax seeds
Flax is native to the region of the eastern Mediterranean to India and also known as common flax or linseed. Flax is an erect annual plant, it can grow to 1.2 m tall. The leaves are 20–40 mm long and 3 mm broad. According to the study by the University of Manitoba, Han:SPRD-cy rats fed flaxseed, showed to preserve renal function and reduce histologic injury, through tissue retention of succinate and betaine which may have a metabolic role in the reduction of chronic renal injury(4). Other study suggested that flax seed diet alters renal content of polyunsaturated fatty acids and promotes the formation of less inflammatory classes of renal prostanoides(5).

2. Organic soybean
Soybean
is genus Glycine, the family Fabaceae, one of the legumes that contains twice as much protein per acre as any other major vegetable or grain crop, native to Southeast Asia. Now, it is grown worldwide with suitable climate for commercial profit and a healthy foods.
Soy protein may be effective in slow progression of renal injury in the Han:SPRD-cy rat, according to the study by theUniversity of Manitoba. The study with Han:SPRD-cy rat, fed with soy protein diet showed to associate with reduced cystic change, epithelial cell proliferation, macrophage infiltration  and fibrosis and prevented a significant elevation in serum creatinine in diseased versus normal animals(6). In Normal (+/+) and affected (cy/+) weanling male and female Han:SPRD-cy rats, soy protein is found to lower IGF-I in +/+ animals, of that supported a role for IGF-I in the pathogenesis of disease in the Han:SPRD-cy rat and an ameliorating role for dietary soy protein(7). Other researchers suggested that isocaloric diets based on 20% casein or 20% heat-treated soy protein at weaning ad libitum for 8 wk, showed a significant effect in  lower serum creatinine (66 vs. 125 mumol/l; P = 0.002), lower urinary ammonium excretion (0.080 vs. 0.173 mmol/kg; P = 0.01), reduced renal cysts, renal fibrosis, macrophage infiltration, renal tubular cell proliferation, and apoptosis(8)

3. Dietary conjugated linoleic acid
Dietary conjugated linoleic acid(CLA) derived from ruminants, found abundantly in diary produces and meats. In  Han:SPRD-cy rat model of polycystic kidney disease (PKD) fed with CLA, showed an reduction of renal production of PGE2, without reduced availability of the precursor fatty acid, AA. Short-term feeding also exhibited significant renal anti-inflammatory and antifibrotic effects(9). Other in the study of Male and female offspring of Han:SPRD-cy heterozygotes fed diets with 0, 1 or 2% CLA isomer mixture for 12 weeks, showed that both CLA diets reduced body fat content in both genders but did not change lean body mass, renal cystic change in female, fibrosis, macrophage infiltration, tissue oxidized LDL content and proliferation of epithelial cells. The study also found significantly increase of serum creatinine in female rat. and with a  significant negative correlation with renal content of the 18:2 c9,t11 isomer and the sum of histologic effects(10).

4. Fish oil
Fish oil containing a large amounts of omega-3 fatty acids may be associated to reduced risk of Polycystic kidney disease.Dietary fish oil (FO) and soy protein (SP) was found to slow Polycystic kidney disease progression in the Han:SPRD-Cy rat model of polycystic kidney disease (PKD), with fish oil through inhibition of both COX and LOX products produced from n-6 fatty acids and increased 3-series prostanoids in both normal and diseased cortex and medulla(11). The Royal Brisbane and Women's Hospital, Brisbane, study showed a potential benefits of omega-3 polyunsaturated fatty acids on the progression of kidney disease and patient survival, as the acids decrease blood pressure, a known accelerant of kidney disease progression(12). But the study at the Kyorin University School of Medicine indicated that Eicosapentaenoic acids (EPA), one of omega3-polyunsaturated fatty acids, show no significant benefits in the testing of non-azotemic patients(13).

Taking altogether, the above list has been found effectively in reduced the progression of inherited Polycystic kidney disease through many different mechanisms. Further studies are necessary to validate theirs effectiveness. As always, all articles written by Kyle J. Norton are for information & education only, please consult your Doctor & Related field specialist before applying



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References
(a) Loss of Polycystin-1 Inhibits Bicc1 Expression during Mouse Development by Lian P1, Li A1, Li Y2, Liu H2, Liang D3, Hu B3, Lin D4, Jiang T5, Moeckel G6, Qin D7, Wu G8.(PubMed)
(b) Reduced ciliary polycystin-2 in induced pluripotent stem cells from polycystic kidney disease patients with PKD1 mutations by Freedman BS1, Lam AQ, Sundsbak JL, Iatrino R, Su X, Koon SJ, Wu M, Daheron L, Harris PC, Zhou J, Bonventre JV.(PubMed)
(c) Polycystin-1 but not polycystin-2 deficiency causes upregulation of the mTOR pathway and can be synergistically targeted with rapamycin and metformin by Mekahli D1, Decuypere JP, Sammels E, Welkenhuyzen K, Schoeber J, Audrezet MP, Corvelyn A, Dechênes G, Ong AC, Wilmer MJ, van den Heuvel L, Bultynck G, Parys JB, Missiaen L, Levtchenko E, De Smedt H.(PubMed)
(1) Metabolic abnormalities in autosomal dominant polycystic kidney disease by Mao Z1, Xie G, Ong AC.(PubMed)
(2)  decrease in kidney size and change in echogenicity occurs, producing a pattern that is similar to that seen on sonograms of patients with autosomal dominant polycystic kidney disease by Blickman JG1, Bramson RT, Herrin JT.(PubMed)
(3) Evidence for a role of proteins, lipids, and phytochemicals in the prevention of polycystic kidney disease progression and severity by Maditz KH1, Gigliotti JC, Tou JC.(PubMed)
(4) The effect of dietary flaxseed supplementation on organic anion and osmolyte content and excretion in rat polycystic kidney disease by Ogborn MR1, Nitschmann E, Bankovic-Calic N, Buist R, Peeling J(PubMed)
(5) [Effect of a modified low protein and low fat diet on histologic changes and metabolism in kidneys in an experimental model of polycystic kidney disease].[Article in Serbian] by Banković-Calić N1, Ogbori MR, Nicman E.(PubMed)
(6) Modification of polycystic kidney disease and fatty acid status by soy protein diet by Ogborn MR1, Nitschmann E, Weiler HA, Bankovic-Calic N.(PubMed)
(7) Dietary soy protein effects on disease and IGF-I in male and female Han:SPRD-cy rats by Aukema HM1, Housini I.(PubMed)
(8) Soy protein modification of rat polycystic kidney disease by Ogborn MR1, Bankovic-Calic N, Shoesmith C, Buist R, Peeling J.(PubMed)
(9) Dietary conjugated linoleic acid reduces PGE2 release and interstitial injury in rat polycystic kidney disease by Ogborn MR1, Nitschmann E, Bankovic-Calic N, Weiler HA, Fitzpatrick-Wong S, Aukema HM.(PubMed)
(10) Dietary conjugated linoleic acid renal benefits and possible toxicity vary with isomer, dose and gender in rat polycystic kidney disease by Ogborn MR1, Nitschmann E, Goldberg A, Bankovic-Calic N, Weiler HA, Aukema HM.(PubMed)
(11) Renal cyclooxygenase and lipoxygenase products are altered in polycystic kidneys and by dietary soy protein and fish oil treatment in the Han:SPRD-Cy rat by Ibrahim NH1, Jia Y, Devassy JG, Yamaguchi T, Aukema HM.(PubMed)
(12) Omega-3 polyunsaturated fatty acids in the treatment of kidney disease by Fassett RG1, Gobe GC, Peake JM, Coombes JS.(PubMed)
(13) he effect of eicosapentaenoic acid on renal function and volume in patients with ADPKD by Higashihara E1, Nutahara K, Horie S, Muto S, Hosoya T, Hanaoka K, Tuchiya K, Kamura K, Takaichi K, Ubara Y, Itomura M, Hamazaki T.(PubMed)