Lifestyle Intervention and Its Effects on Inflammatory Cytokines and Oxidative Stress Markers in Diabetic Chronic Kidney Disease Patients: A Randomized Controlled Trial

Abstract

Background: The presence of type 2 diabetes mellitus aggravates chronic kidney disease in patients due to an increased level of oxidative and chronic low-grade inflammation which substantially elevate cardiovascular risk. Lifestyle modifications, particularly aerobic exercise and dietary changes, are promising non-pharmacological interventions for this population. Objective: This is an evaluation of a 12-week structured intervention on lifestyle on inflammatory cytokines and oxidative stress biomarkers of overweight adults with T2DM and moderate CKD. Methods: Sixty sedentary participants (aged 36–58 years) with CKD stages 3–4 (eGFR 25–60 mL/min/1.73 m²), T2DM, and BMI 30–35 kg/m² were randomly assigned to an intervention group (supervised aerobic exercise and a calorie-restricted diet of 1200 kcal/day) or a control group (standard care). Biomarkers (TNF-α, IL-6, sCRP, MDA, CD, GSH, GPx, SOD) were assessed at baseline and after 12 weeks. Results: The intervention group demonstrated significant reductions in BMI, inflammatory cytokines (TNFα, IL-6, sCRP), and oxidative stress markers (MDA, CD), alongside significant improvements in antioxidant enzymes (GSH, GPx, SOD) (all p<0.05). No significant changes were observed in the control group. Conclusion: A 12-week lifestyle intervention significantly improves inflammatory and oxidative stress profiles in overweight patients with diabetic CKD, supporting its integration into clinical management to reduce cardiovascular risk and slow disease progression.