Mediterranean Diet Adherence and Oxidative Stress in Autosomal Dominant Polycystic Kidney Disease: A Cross-Sectional Analysis of sNOX2-dp and Hydrogen Peroxide Concentration

: Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder marked by progressive kidney enlargement and cyst formation, often resulting in end-stage renal disease (ESRD). Oxidative stress (OxS) significantly contributes to renal damage in chronic kidney disease (CKD) and ADPKD. While the Mediterranean diet (Med-diet) is known for its antioxidative and anti-inflammatory effects, its impact on OxS in ADPKD remains unclear. This study aimed to assess the relationship between adherence to the Med-diet, OxS levels, and renal function in ADPKD patients. We enrolled 63 ADPKD patients aged 18-70 years with CKD stages G2-G4. Adherence to the Med-diet was evaluated using the PREDIMED questionnaire. OxS markers (NOX2-derived peptide [sNOX2-dp] and hydrogen peroxide [H2O2]) were measured via ELISA. Correlations between these markers, Med-diet adherence, serum creatinine, and estimated glomerular filtration rate (eGFR) were analyzed. Higher adherence to the Med-diet was associated with significantly lower OxS markers (sNOX2, p < 0.001; H2O2, p = 0.04). Reduced NOX2 and H2O2 levels correlated with lower creatinine and higher eGFR (NOX2, p < 0.001; H2O2, p < 0.001), suggesting an inverse relationship between OxS and renal function. In conclusion, adherence to the Mediterranean diet appears to be associated with lower levels of oxidative stress and may slow the progression of chronic kidney disease. These findings suggest that dietary interventions could mitigate disease progression by modulating OxS. Further studies are needed to confirm these results and explore the long-term effects of the Med-diet on disease progression.