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

Abstract

Patients undergoing maintenance dialysis have a significantly higher incidence of cardiovascular disease (CVD) compared with the general population. CVD is the most common cause of morbidity and mortality among hemodialysis patients, and has been attributed, among other causes, to increased oxidative stress, inflammation, hypertension and dyslipidemia. Pomegranate, a popular fruit worldwide, has demonstrated health benefits such as antioxidative, antidiabetic, antihypertensive, antihyperlipidemic and anti‐inflammatory effects. In this systematic review of clinical trials, we aim to summarize the effect of different parts of pomegranate and the effects of its use on CVD risk factors in hemodialysis patients. PubMed/MEDLINE, EMBASE, Scopus, and Web of Science were searched to identify eligible clinical trials up to December 2021. Ultimately, seven clinical trials were included in this study. Different parts of pomegranate used in these trials were pomegranate juice, pomegranate extract and pomegranate peel extract. The duration of the studies varied from one dialysis session to 1 year. Our results showed that different parts of pomegranate may have anti‐hypertensive, antioxidant, anti‐inflammatory effects and improve lipid profile by decreasing TG (triglycerides) and increasing HDL‐C (high‐density lipoprotein cholesterol) in hemodialysis patients. However, due to limited number of studies, more clinical trials need to be performed.

Effects of Cranberry Extract (Vaccinium macrocarpon) Supplementation on Lipid Peroxidation and Inflammation in Patients with Chronic Kidney Disease (Stages 3-4): A Randomized Controlled Trial

“…Several studies have used bioactive compounds obtained from food as a complementary therapy in CKD treatment because of their many benefits, including antihypertensive properties, amelioration of lipoprotein profile, and antioxidant and anti-inflammatory effects through the modulation of transcription factors involved in inflammation and oxidative stress, which can slow CKD progression [ 15 , 17 , 18 , 23 , 27 ]. Advanced stages of CKD usually present with altered transcription factor expression, indicating higher NF-kB mRNA expression and decreased Nrf2 mRNA expression compared with healthy individuals [ 39 ].…”

“…Bioactive compounds found in plant foods have several properties, such as anti-inflammatory, antioxidant, antiproliferative, and antihypertensive effects, as well as modulation of cardiovascular risk markers [ 16 – 19 ]. Therefore, several researchers have used herbs and natural substances as complementary therapies for chronic diseases and CKD because of their antioxidant, antihypertensive, and anti-inflammatory effects, lipid profile improvement [ 17 ], and modulation of transcription factors involved in inflammation and oxidative stress, which can slow CKD progression [ 20 – 23 ]. In this context, the use of bioactive compounds from food [ 24 ] (resveratrol, curcumin, sulforaphane, and catechins, among others) has been discussed in the concept of food as medicine for patients with chronic diseases and CKD [ 25 – 27 ].…”

Unlocking the therapeutic treasure of pomegranate leaf: A comprehensive review on phytochemical compounds, health benefits, and future prospects

“…Indeed, recent clinical trials have highlighted the health benefits of pomegranate. The study by Baghdadi et al (2023) reviewed the impact of various pomegranate parts on cardiovascular disease risk factors in patients undergoing maintenance dialysis. This systematic review found significant anti-hypertensive, antioxidant, and anti-inflammatory effects, along with improved lipid profiles.…”

“…Every part of the pomegranate tree, from its aril, peel, and seed to its flower, leaf, bark, and root, serves as a testament to nature's bounty, brimming with therapeutic properties ( Melgarejo-Sánchez et al, 2021 ; Ranjha et al, 2021 ). However, the global research community has predominantly focused on the fruit, namely its juice, due to its rich bioactive components and plenty of health benefits, even the peel and seeds are explored gradually ( Baghdadi, Shidfar, & Dehnad, 2023 ; B. Singh et al, 2018 ).…”