Niacin Reduces Kidney Damage
ironjustice
and hypertension in rats with chronic renal failure
Am J Physiol Renal Physiol 297: F106-F113, 2009.
Kyu-hyang Cho,1,2 Hyun-ju Kim,1
Bernardo Rodriguez-Iturbe,3 and Nosratola D. Vaziri1
1Division of Nephrology and Hypertension,
University of California, Irvine, California;
2Department of Internal Medicine, Yeungnam University, Daegu, Korea;
and 3Renal Service, Hospital Universitario,
Universidad del Zulia and Centro de Investigaciones Biomédicas (IVIC-
Zuli),
Maracaibo, Venezuela
Submitted 4 March 2009 ; accepted in final form 28 April 2009
Significant reduction of renal mass causes progressive deterioration
of
renal function and structure which is mediated by systemic and
glomerular
hypertension, hyperfiltration, oxidative stress, inflammation, and
dyslipidemia.
Niacin is known to improve lipid metabolism and exert antioxidant/anti-
inflammatory
actions.
Therefore, we considered that niacin supplementation may attenuate
oxidative
stress, inflammation, and tissue injury in the remnant kidney.
To this end, nephrectomized [chronic kidney disease (CKD)] rats were
randomly
assigned to niacin-treated (50 mg·kg-1·day-1 in the drinking water for
12 wk)
and untreated groups. Sham-operated rats served as controls.
The untreated CKD rats exhibited azotemia, hypertension,
hypertriglyceridemia,
proteinuria, glomerulosclerosis, tubulointerstitial damage,
upregulation of MCP-1,
plasminogen activator inhibitor-1 (PAI-1), transforming growth factor
(TGF)-β,
cyclooxygenase (COX)-1, COX-2, and NAD(P)H oxidase (NOX-4, gp91phox,
p47phox and p22phox subunits) and activation of NF-B (IB
phosphorylation).
Niacin administration reduced MCP-1, PAI-1, TGF-β, p47phox, p22phox,
COX-1, and NF-B activation, ameliorated hypertension, proteinuria,
glomerulosclerosis, and tubulointerstitial injury.
Although niacin lowered serum creatinine and raised creatinine
clearance,
the differences did not reach statistical significance.
Thus niacin supplementation helps to attenuate histological injury and
mitigate
upregulation of oxidative and inflammatory systems in the remnant
kidney.
malnutrition; glomerulosclerosis; fibrosis; TGF; CTGF; NAD(P)H
oxidase;
cyclooxygenase; NF-B; lipid disorder; atherosclerosis
Address for reprint requests and other correspondence: N. D. Vaziri,
Div. of Nephrology and Hypertension, UCI Medical Center,
101 The City Dr., Orange, CA 92868
(e-mail: ndva...@uci.edu)
First published May 6, 2009; doi:10.1152/ajprenal.00126.2009
0363-6127/09 $8.00
Copyright (c) 2009 by the American Physiological Society.
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Tom
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Ron
Ron
2007 & I am equally indebted to each of you for your guidance. GOD
bless..Ron in Milton, Fl.
mainframetech
Ron,
Glad to hear you're hanging in. I recently stopped taking
lisinopril because it retains potassium, I believe. Check it out.
I've gone further sdown the road with an eGFR of probably 30 and Serum
Creatinine or 2.1. I had some bad tooth pain and used a lot of NSAIDS
and the dentist pushed my BP way up with pain. I recently got out of
the hospital emergency room from going in with a kidney stone. I
never had them, but now I ahve 2. I suspect that Walser's diet and my
love of salt might be at the heart of that. After the doctor's began
arguing in the hospital about what tests and keeping me overnignt and
so on, I just left. The pain had suddenly stopped, and although I
figure it will come back, I couldn't take the low cholesterol diet
they would put me on. I'm not a big believer that lowering
cholesterol is critical for most people. Perhaps some with numbers as
high as yours, but not fgor me. I want my cholesterol and I'm not
giving it up... :)
Good luck,
Chris
mainframetech
Just for general grins and giggles, I checked and found that many
sites do not recommend taking extra doses of niacin with kidney
disease. Check it for yourself and make your decisions.
Good luck,
Chris
R D
mainframetech
Ron,
My take based on looking around is that Lisinopril and other ACE
inhibitors will cause you to retain potasium. Also there is always
the recommendation to let your physician know you have CKD as they may
have to 'adjust' your dosage.
I'm going to get rid of the Lisinopril as soon as I can. Also. I
don't much like statins considering all the damage they do, and the
fact that most people's cholesterol is perfectly OK. Read "The
Cholesterol Myths" by Uffe Ravnskov, MD. Also visit www.spacedoc.net
which is devoted to research odf statins that is free of the
everpresent drug companies.
Good Luck,
Chris
Ron D
Good hearing from you. As i said Lisinopril pulled me back from
pulmonary hypertension years ago when other medications were not doing
the job. Initially when my KCL was way high my Nephrologist took me off
Maxide which is a KCL sparing diuretic replacing it with
Terazosin 1 mg @ bedtime. This worked along with dietary KCL
restrictions.
This year, when my BP was creeping back up, instead of increasing my low
dose lisinopril, we added 0.1 mg of Clonidine in the morning (Catapress,
an alpha antagonist). We could not use a Beta blocker because of my
asthma. Thus far I remain in high stage 3 with high normal creatine
level & high normal KCL level with lab draws every 6 weeks. I test for
protein leakage 3 times a week, all NEG.
Anemia is my big curse but has improved with cautious use of Aranesp
injections. I'll be 70 next week. Thanks for all your input's Chris & I
certainly wish you GOD's grace in your own battle.. Ron in Fl.
mainframetech
Ron,
For me, Lisinopril didn't do that much, but each person is
different in what affects them. I'm using clonidine and it was very
powerful for me. Nothing else was bringing my BP down until one
doctor gave me clonidine.
I've found that using an Excel spreadsheet to record my lab results
has been very useful. My doctors think so too, because I give them a
copy. I have been recording RBC for 3-4 years, and for some reason,
although my count is down just below the limit, it hasn't moved from
there for all this time. I won't take anything extra that I can
avoid. I've found in some cases that you take one drug they recommend
and it forced you to take another that is currently being
advertised.
Do you suppose that the drug companies are aware that they are
making their own products necessary? You bet. And you can bet they
are also looking for drugs that will help you a little but serve only
to prolong your problem, and never to fix it.
I once had my own pharmacist say "you know, if they cured people,
they would go out of business". I knew it but to have a pharmacist
say it was a strong statement.
Good luck,
Chris
Ron D
"Give a man a fish & he eats for a day, Teach him to fish & you destroy
your whole market base". <>G<> Ron
mainframetech
> 7 years ago (before CKD), my cholesterol was 302. They tried me on
> Pravachol & Lipitor. Both made me very ill (Thankfully). I then went on
> NIACIN 500 mg time release caplets 3 times a day. I also lost down from
> 238# to the 185 # range & have stayed within in 5# all this time. I
> shutter to think where my CKD would have been if I had stayed on statins
> all that time. My last cholesterol was 142. bad cholesterol 85 & good
> 38. My B/P remains nice & low (115/66 My CKD remains stage 3 with help
> from Dr Walsers book & a Nephrologist that really works in my interest.
> I've learned to live with the diet restrictions w/o too much problem. My
> major problems with the kidneys is the anemia. I just had a hgb of 10.2
> along with pneumonia. Thanks to antibiotics & Aranesp injections I feel
> great & will be re-tested 7/13/09. I'll turn 70 in August & feel that
> something else will eventually get me ie: my lung diseases or a crashing
> satellite. My Nephrologist concurs.
> You & others in this group steered me in the right direction when I was
> diagnosed in February of 2007 & I'm grateful. (I used to post with the
> nic of: RONINMILTON).
> To get back on track.The NIACIN worked for cholesterol control,
> LISINOPRIL worked for B/P & 10 dried cherries a day has kept the GOUT
> (ouchie), @ bay w/o Allipurinol. Thank you again for your help in the
> past & I hope you are doing well. GOD bless.. Ron in Milton, Fl.
>
>
Ron,
It's always good to hear of someone that has been successful at
holding off the spectre of dialysis, especially using the low protein
diet. I'm also glad to hear that you were able to get away from
statins. I believe that if you're concerned about adverse heart
events, look into managing your homocysteine level. Vitamins B6, B12
and Folic Acid do it very well. Check with your doctor, though he may
have been brainwashed by the drug companies into prescribing statins
at the drop of a hat. Here's a link to an article entitled "First
Comprehensive Paper on Statin's Adverse Effects Released". It quoted
over 900 studies demonstrating negative effects of statins:
http://www.eurekalert.org/pub_releases/2009-01/uoc--fcp012609.php
Would you believe that the so-called scientific world has done a
study 'proving' that the very low protein diet of Mackenzie Walser
doesn't work, and even can lead to problems of lacks in the diet! The
study is known as the MDRD study. This study is quoted by so many
other researchers that they will actually believe the results I
mentioned. Our 'anecdotal' evidence will be pushed aside and ignored
by the 'wiser heads' of the scientific world.
I know from watching my numbers closely that my progress toward
dialysis has been dramatically slowed by the very low protein diet,
and they can't convince me otherwise. So I will continue to recommend
the book "Coping With Kidney Disease" by Mackenzie Walser. He was a
researcher in Kidney Disease at Johns Hopkins for 45 years. Check
with your nephrologist, though he too will probably quote some dumb
study that says it does no good. I'm told by a nurse that many
nephrologists profit from getting people into dialysis sooner.
I can only think that the drug companies sponsored the studies so
that more people would go into dialysis sooner so that profits can be
made. But then I'm a cynical SOB... :)
Good luck,
Chris
mainframetech
Ron D,
LOL! Ain't it the truth! :) Some interesting news. About 2
months ago a nagging personal problem resolved itself and I have been
relieved for a while now. My latest lab report went from my sudden
drop to 2.1 Serum Creatinine to 1.78. The eGFR went from 32 to 38!!
I had stopped taking Lisinopril, but also had this relief happen. So
now I go to get labs again and I'll see if the change 'took', or was
only a temporary blip on the horizon... :)
Good Luck,
Chris
Somebody
4899-8b6e-c...@b14g2000yqd.googlegroups.com:
As an Engneer, I have a comment on this. The reason the "so-called
Scientific Community" believes these studies is because they are
repeatable. If another group in another area of the world performs the
same study using exactly the same methos, they will get pretty much
exactly the same result for the data. If they don't, the original study
will be discredited. If the study is discredited enough, it will be
discarded as invalid. This is what happened with that British study
that established the connection between childhood vaccinations and
Autism. The study was done five times around the world, and all the
redone studies didn't prove anything. In fact, the British goverbment
ultimately investigated the Study authors and determined that they
tampered with the data to get the result they wanted.
As to the Anecdotal evidence part, The reason it is not considered
valid is that ubtil a formal study confirms it, as some anecdotal claims
have, it is just that, anecdotal. There is no proof that is true.
Think of it this way. A car accident happens at an intersection. There
are 20 people who witness the sccident, from positions all around the
accident. If you interview the 20 witnesses, the likelyhood that even a
majority will report the same thing is low.
I don't dismiss anecdotal evidence out of hand, but I am suspicious of
them. Its like with the suppliment industry. In the US, they don't
have to prove that the suppliments they market work for what they claim,
they don't even have to prove they are safe to use for a healthy
individual. They usually present anecdotal evidence that it does what
they say and that it is safe. But even somebody that only paya marginal
attention to world news will notice that hundreds of suppliments have
been pulled from the market because of serious medical issues developed
because of these suppliments. If the suppliment industry want to really
convince the public of what they believe, they would run legitimate
studies to prove them. The reason they don't is because even they don't
believe what they claim. I know it is expensive to run studies, but the
expense will be recovered if the studies prove what they are claiming.
If not, they stop marketing that product.
Another problem with anecdotel evidence is that there is no way of
knowing if the person making the anecdotal statement is even telling the
truth. Are they getting paid? Getting some other benefit? Is it just a
placebo effect?
Again, I am not against alternative medicins and suppliments per sey.
If it really works for you, well fine. What usually shows up over time
is they don't work, or don't work as well, for most others in the
population.
Again, I expect to get flamed heavily for these comments.
Dave.
Ron D
I believe it was GOD's blessings that I was not able to take the statins
at all. That was 7 years ago the end of this month. Been on the niacin
ever since. You mentioned when I first posted over 2 years ago that
there were rumours some Nephrologist get patients into dialysis early
for financial gain. I confronted my Nephrologist with this rumor at the
get go. He denied it happens BUT has worked in my interest with good
success. I'm happy with him & he is happy with my numbers.
There is a neat thing about the niacin. IF...It should bother your liver
it produces liver pain. Stop the niacin & there is no harm. Statins
DAMAGE the liver w/o warning until too late. I do have a liver profile
every 3 months as part of my monitoring prodigal. Ron
Ron D
your next lab draw say's.. Ron
Ron D
many fields not just medicine or health. Many are re-written old studies
with enough changes to qualify for government research grants. Ron
mainframetech
Ron,
The next labs had an eGFR of 35. Down 3 points, a large amount for
me. I'm still suspicious of the lisinopril, at least in my system.
It may be OK for others. I may stop taking it again.
Good luck,
Chris