Genetic damage and oxidative stress in patients with chronic kidney disease and type 2 diabetes mellitus: a scoping review
Keywords:
Chronic kidney disease, type 2 diabetes mellitus, comet assay, genetic damageAbstract
Introduction: Type 2 diabetes mellitus is one of the leading causes of chronic kidney disease (CKD) in Paraguay, a public health issue that significantly affects patients’ quality of life. This scoping review examines the relationship between DNA damage and hemodialysis treatment in patients with CKD and type 2 diabetes, a population with high prevalence and risk of associated complications. The primary objective was to synthesize the scientific evidence on the level of genotoxic damage in diabetic patients with CKD undergoing hemodialysis. Methodology: Twelve studies published since 2010 were selected, primarily using the comet assay to measure DNA damage, supplemented in some cases by other bioassays to assess oxidative damage and inflammatory biomarkers. The methodology included searches in Google Scholar with specific keywords, selection based on rigorous inclusion criteria, and manual analysis supported by artificial intelligence tools for data extraction. Results: The results show significantly higher genetic damage in CKD patients on hemodialysis compared to healthy controls, though with conflicting findings regarding the direct impact of hemodialysis on DNA damage. Factors such as duration, frequency, and modality of dialysis, as well as individual DNA repair capacity, influence the level of damage detected. Certain modalities, such as hemodiafiltration and peritoneal dialysis, showed potential to reduce genotoxic damage. Conclusion: Genetic damage appears to be an inherent feature of CKD, with hemodialysis possibly amplifying this effect under certain conditions. The need for further research to clarify these relationships and optimize clinical strategies to mitigate DNA damage in this vulnerable population is emphasized.
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