Effects of pomegranate juice on cardiometabolic risk factors and biomarkers of oxidative stress and inflammation in hemodialysis patients, a crossover controlled trial

Abstract

Background: Pomegranate has antioxidant, cardioprotective, and anti-inflammatory properties. We questioned if pomegranate juice (PJ) benefits lipid profile and oxidative and inflammatory biomarkers of hemodialysis patients. Methods: The study had a crossover design. Hemodialysis patients (n=41) were divided into two groups: PJ-treated group who received 100 ml natural PJ immediately after their dialysis session three times a week and the control group who received the usual care. After 8 weeks, a 4-week washout period was established and afterwards the role of the groups was exchanged. Lipid profile, blood pressure, and oxidative and inflammatory biomarkers were measured before and after each sequence. Comparisons between the two conditions were performed by ANCOVA with adjustments for potential confounders. Results: Based on results of intention-to-treat analysis, triglycerides were decreased in PJ condition and increased in the control. Conversely, high-density lipoprotein (HDL)-cholesterol was increased in PJ and decreased in control. There was a significant between-condition difference for both triglycerides and HDL-cholesterol (P<0.001). Total and low-density lipoprotein (LDL)-cholesterol did not significantly change in either condition. Systolic and diastolic blood pressure significantly decreased in PJ condition and caused a significant difference between two conditions (P<0.001). Total antioxidant capacity increased in PJ condition (P<0.001) and decreased in control (P<0.001). Conversely, malondialdehyde and interleukin-6 decreased in PJ (P<0.001) and increased in the control (P≤0.001). The changes of these biomarkers were significantly different between two conditions. Conclusions: In conclusion, 8-week PJ consumption showed beneficial effects on blood pressure, serum triglycerides, HDL cholesterol, oxidative stress, and inflammation in hemodialysis patients. The trial was registered at Iranian Registry of Clinical Trials (ID number: IRCT 2016070428797N1). Keywords: Pomegranate, hemodialysis, hypertension, oxidative stress, inflammation, lipid profile.

The effect of pomegranate consumption on cardiovascular risk factors in hemodialysis patients: A systematic review of clinical trials

“…Two of them showed significant reduction in systolic blood pressure and one reported significant reduction in diastolic blood pressure. In a cross over trial, systolic(135.65 ± 8.47 vs. 128.96 ± 6.11 mmHg) and diastolic (97.73 ± 9.95 vs. 90.84 ± 6.86 mm Hg) blood pressure significantly decreased in the pomegranate juice group ( p < 0.001) after 8 weeks of using 100 mL pomegranate juice following each dialysis session Systolic blood pressure increased significantly in the control group and the difference between the pomegranate juice group and control group for both systolic (−6.97 vs. 0.97 mm Hg) and the diastolic (−6.88 vs. 0.98 mm Hg) blood pressure was significant ( p < 0.001) (Boldaji et al, 2019). Wu et al reported that daily use of pomegranate extract (1000 mg) for 6 months resulted in a decrease of systolic blood pressure and diastolic blood pressure by 13% ( p < 0.05) and 11% ( p < 0.05), respectively, in the pomegranate extract group, but did not change in the control group.…”

“…We also tried to obtain the full text, and the articles were managed using EndNote software. Finally, implementing the search strategy, we identified nine articles (7 RCTs) that fulfilled the eligibility criteria (Boldaji et al, 2019; Jafari, Fallah, Bahrami, & Lorigooini, 2020; Jafari, Fallah, Reyhanian, & Sarmast, 2020; Rivara et al, 2015; Shema‐Didi et al, 2013; Shema‐Didi et al, 2014; Shema‐Didi et al, 2012; Wu et al, 2015; Yavari et al, 2017) (Figure 1).…”

“…Effect of pomegranate on blood pressure Four studies investigated blood pressure as an outcome (Boldaji et al, 2019; Rivara et al, 2015; Shema‐Didi et al, 2014; Wu et al, 2015). Two of them showed significant reduction in systolic blood pressure and one reported significant reduction in diastolic blood pressure.…”

“…In five studies the effect of pomegranate on blood lipid profile was evaluated (Boldaji et al, 2019; Rivara et al, 2015; Shema‐Didi et al, 2014; Wu et al, 2015; Yavari et al, 2017), among which two studies reported significant reduction in TG and significant increase in HDL cholesterol (HDL‐C) (Boldaji et al, 2019; Shema‐Didi et al, 2014) According to Barati Boldaji et al TG decreased in the pomegranate juice group ( p < 0.001) and increased in the control group ( p = 0.007). In contrast, HDL‐C increased in the pomegranate juice group ( p < 0.001) and decreased in the controls ( p = 0.001).…”

The Design, Synthesis, and Biological Evaluation of Compounds with Medicinal Value

“…On the other hand, high-density lipoprotein cholesterol was increased after PJ assumption, whereas total and low-density lipoprotein cholesterol were not affected. Systolic and diastolic blood pressure dramatically fell in the PJ condition, while total antioxidant capacity increased [121].…”