One year of pomegranate juice intake decreases oxidative stress, inflammation, and incidence of infections in hemodialysis patients: A randomized placebo-controlled trial

Lilach Shema-Didi, Shifra Sela, Liora Ore, Galina Shapiro, Ronit Geron, Goldfeld Moshe, Batya Kristal

Research output: Contribution to journalArticlepeer-review

111 Scopus citations

Abstract

Increased systemic inflammation and oxidative stress are well established as nontraditional key players in the pathogenesis of atherosclerosis and are also involved in the innate immunity dysregulation in hemodialysis (HD) patients. The study aim was to investigate the effect of 1-year intake of pomegranate juice, an antioxidant source, on oxidative stress, inflammation, and long-term clinical outcomes. A randomized placebo controlled double-blind trial was designed, enrolling 101 chronic HD patients to receive during each dialysis 100 cc of pomegranate juice, or matching placebo, three times a week for 1 year. The primary endpoints were levels of oxidative stress and inflammation biomarkers. Secondary endpoints were hospitalization due to infections and the progression of atherosclerotic process based on a composite of variables of the carotid arteries: intima media thickness (IMT), number, and structure of plaques. Pomegranate juice intake yielded a significant time response reduction in polymorphonuclear leukocyte priming, protein oxidation, lipid oxidation, and inflammation biomarkers levels. These beneficial effects were abolished 3 months postintervention. Pomegranate juice intake resulted in a significantly lower incidence rate of the second hospitalization due to infections. Furthermore, 25% of the patients in the pomegranate juice group had improvement and only 5% progression in the atherosclerotic process, while more than 50% of patients in the placebo group showed progression and none showed any improvement. Prolonged pomegranate juice intake improves nontraditional CV risk factors, attenuates the progression of the atherosclerotic process, strengthens the innate immunity, and thus reduces morbidity among HD patients.

Original languageEnglish
Pages (from-to)297-304
Number of pages8
JournalFree Radical Biology and Medicine
Volume53
Issue number2
DOIs
StatePublished - 15 Jul 2012

Bibliographical note

Funding Information:
This study was supported by Grant 6186 from the Chief Scientist Office of the Ministry of Health, Israel ; Grant 2012255 from Jess & Midred Fisher Family Cardiology Research Fund , Office of the Executive Vice President for Research, Technion, Israel; and by Iscar Ltd. The authors are indebted to Hadya Sabik (B.Sc) from the Research Laboratory, Western Galilee Hospital, for the biomarkers analysis. The authors declare no financial conflict of interest.

Keywords

  • Hemodialysis
  • Inflammation
  • Oxidative stress
  • Pomegranate juice

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