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

• Published in: Free radical biology & medicine Vol. 53; no. 2; pp. 297 - 304
• Main Authors: Shema-Didi, Lilach, Sela, Shifra, Ore, Liora, Shapiro, Galina, Geron, Ronit, Moshe, Goldfeld, Kristal, Batya
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.07.2012
• Subjects: Aged; Aged, 80 and over; antioxidants; Antioxidants - administration & dosage; atherosclerosis; Atherosclerosis - drug therapy; Atherosclerosis - pathology; Bacterial Infections - epidemiology; Bacterial Infections - prevention & control; Beverages; biomarkers; Biomarkers - analysis; carotid arteries; Carotid Arteries - drug effects; Carotid Arteries - pathology; Carotid Intima-Media Thickness; dialysis; Double-Blind Method; Female; Hemodialysis; Humans; Incidence; Inflammation; Inflammation - drug therapy; Inflammation - pathology; innate immunity; juices; leukocytes; lipid peroxidation; Lipid Peroxidation - drug effects; Male; Middle Aged; morbidity; oxidation; Oxidative stress; Oxidative Stress - drug effects; pathogenesis; patients; Phytotherapy - methods; Plaque, Atherosclerotic - drug therapy; Plaque, Atherosclerotic - pathology; Pomegranate juice; pomegranates; Punicaceae; randomized clinical trials; Renal Dialysis; risk factors; Treatment Outcome; Oxidative stress; Inflammation; Hemodialysis; Pomegranate juice
• ISSN: 0891-5849; 1873-4596
• DOI: 10.1016/j.freeradbiomed.2012.05.013

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 100cc 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. ► Pomegranate juice intake attenuates oxidative stress in hemodialysis (HD) patients. ► One year of pomegranate juice intake attenuates inflammation in HD patients. ► Pomegranate juice intake attenuates progression of atherosclerosis in HD patients. ► Pomegranate juice intake lowers hospitalization of HD patients due to infections.