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.