The Effect of Pomegranate Juice (PJ) on Oxidative Stress Biomarkers During Treatment With IV Iron During One Dialysis Session
NCT ID: NCT02107053
Last Updated: 2016-02-09
Study Results
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Basic Information
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COMPLETED
NA
25 participants
INTERVENTIONAL
2014-04-30
2016-01-31
Brief Summary
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Detailed Description
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Recently, the investigators have reported that half a cup of pomegranate juice (PJ), exceptional for its highest levels of antioxidants, administered 3 times a week for one year at the beginning of each dialysis, had many beneficial effects. The PJ led to a significant reduction of the atherosclerotic process and the rate of hospitalization due to infections: It lowered traditional CV risk factors such as high blood pressure and lipids (triglycerides levels). It improved various systemic non-traditional cardiovascular risk factors such as neutrophil priming, oxidation adducts and pro-inflammatory factors (IL-6, TNFα). Neutrophil priming was previously reported by us as a unique non-traditional CV risk factor involved in different clinical states associated with atherosclerosis. Moreover, the investigators have shown that primed neutrophils separated from HD patients cause endothelial injury that may lead to atherosclerosis and CVD.
The PJ is, thus, effective, vital and important. Yet the PJ in its natural liquid state has an astringent taste and raises doubts and uncertainties with regards to its non-standardized commercial preparation, of undefined composition and shelf life.
The investigators propose to examine PJ or pomegranate extracts containing similar concentrations of total polyphenols as in the investigators previous study in the Turkish juice (ref #2 below), in order to make it more standardized as a dietary supplement to hemodialysis patients.
The investigators plan in this protocol to study the effects of a chosen pomegranate extracts or juice from Primor, in a clinical study in HD patients. The study will be performed in one dialysis session, with and without IV iron and with and without pomegranate juice (4-arms, same patient). Each dialysis session activates neutrophils and induces oxidative stress and inflammation. Therefore, in this clinical study the investigators will assay the beneficial effects of the PJ on oxidative stress and inflammation induced by one dialysis session exacerbated by IV iron.
Each patient will be treated the same day of the week, 4 times, altogether one month per patient.
Conditions
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Study Design
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NON_RANDOMIZED
PARALLEL
BASIC_SCIENCE
SINGLE
Study Groups
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IV iron + PJ
Each patient will serve as a self control
PJ
IV iron
IV iron is routinely administered to dialysis patients worldwide to correct anemia
No IV iron + PJ
Each patient will serve as a self control
PJ
IV iron no PJ
Each patient will serve as a self control
IV iron
IV iron is routinely administered to dialysis patients worldwide to correct anemia
Interventions
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PJ
IV iron
IV iron is routinely administered to dialysis patients worldwide to correct anemia
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
20 Years
95 Years
ALL
No
Sponsors
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Luoxis
INDUSTRY
Western Galilee Hospital-Nahariya
OTHER_GOV
Responsible Party
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shifra sela
Head of Research Labs
Principal Investigators
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Batya Kristal, MD
Role: PRINCIPAL_INVESTIGATOR
Western Galilee Hospital
Locations
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Western Galilee Hospital
Nahariya, , Israel
Countries
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References
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Shema-Didi L, Kristal B, Ore L, Shapiro G, Geron R, Sela S. Pomegranate juice intake attenuates the increase in oxidative stress induced by intravenous iron during hemodialysis. Nutr Res. 2013 Jun;33(6):442-6. doi: 10.1016/j.nutres.2013.04.004. Epub 2013 May 9.
Shema-Didi L, Sela S, Ore L, Shapiro G, Geron R, Moshe G, Kristal B. One year of pomegranate juice intake decreases oxidative stress, inflammation, and incidence of infections in hemodialysis patients: a randomized placebo-controlled trial. Free Radic Biol Med. 2012 Jul 15;53(2):297-304. doi: 10.1016/j.freeradbiomed.2012.05.013. Epub 2012 May 17.
Sela S, Michelis R, Kristal B. Are oxidative modifications of proteins a metabolomic signature of cardiovascular disease in CKD? Am J Kidney Dis. 2013 Feb;61(2):350-1. doi: 10.1053/j.ajkd.2012.10.022. No abstract available.
Cohen-Mazor M, Sela S, Mazor R, Ilan N, Vlodavsky I, Rops AL, van der Vlag J, Cohen HI, Kristal B. Are primed polymorphonuclear leukocytes contributors to the high heparanase levels in hemodialysis patients? Am J Physiol Heart Circ Physiol. 2008 Feb;294(2):H651-8. doi: 10.1152/ajpheart.00952.2007. Epub 2007 Nov 21.
Mazor R, Kristal B, Cohen-Mazor M, Yagil C, Yagil Y, Sela S. The polymorphonuclear leukocyte contributes to the development of hypertension in the Sabra rat. J Hypertens. 2007 Nov;25(11):2249-56. doi: 10.1097/HJH.0b013e3282dd79b6.
Mazor R, Shurtz-Swirski R, Farah R, Kristal B, Shapiro G, Dorlechter F, Cohen-Mazor M, Meilin E, Tamara S, Sela S. Primed polymorphonuclear leukocytes constitute a possible link between inflammation and oxidative stress in hyperlipidemic patients. Atherosclerosis. 2008 Apr;197(2):937-43. doi: 10.1016/j.atherosclerosis.2007.08.014. Epub 2007 Sep 17.
Jacobi J, Sela S, Cohen HI, Chezar J, Kristal B. Priming of polymorphonuclear leukocytes: a culprit in the initiation of endothelial cell injury. Am J Physiol Heart Circ Physiol. 2006 May;290(5):H2051-8. doi: 10.1152/ajpheart.01040.2005. Epub 2005 Dec 30.
Jacobi J, Kristal B, Chezar J, Shaul SM, Sela S. Exogenous superoxide mediates pro-oxidative, proinflammatory, and procoagulatory changes in primary endothelial cell cultures. Free Radic Biol Med. 2005 Nov 1;39(9):1238-48. doi: 10.1016/j.freeradbiomed.2005.06.010. Epub 2005 Aug 8.
Sela S, Shurtz-Swirski R, Cohen-Mazor M, Mazor R, Chezar J, Shapiro G, Hassan K, Shkolnik G, Geron R, Kristal B. Primed peripheral polymorphonuclear leukocyte: a culprit underlying chronic low-grade inflammation and systemic oxidative stress in chronic kidney disease. J Am Soc Nephrol. 2005 Aug;16(8):2431-8. doi: 10.1681/ASN.2004110929. Epub 2005 Jun 29.
Sela S, Mazor R, Amsalam M, Yagil C, Yagil Y, Kristal B. Primed polymorphonuclear leukocytes, oxidative stress, and inflammation antecede hypertension in the Sabra rat. Hypertension. 2004 Nov;44(5):764-9. doi: 10.1161/01.HYP.0000144480.10207.34. Epub 2004 Sep 27.
Shurtz-Swirski R, Sela S, Herskovits AT, Shasha SM, Shapiro G, Nasser L, Kristal B. Involvement of peripheral polymorphonuclear leukocytes in oxidative stress and inflammation in type 2 diabetic patients. Diabetes Care. 2001 Jan;24(1):104-10. doi: 10.2337/diacare.24.1.104.
Kristal B, Shurtz-Swirski R, Chezar J, Manaster J, Levy R, Shapiro G, Weissman I, Shasha SM, Sela S. Participation of peripheral polymorphonuclear leukocytes in the oxidative stress and inflammation in patients with essential hypertension. Am J Hypertens. 1998 Aug;11(8 Pt 1):921-8. doi: 10.1016/s0895-7061(98)00099-5.
Other Identifiers
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0122-13
Identifier Type: -
Identifier Source: org_study_id
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