Effects of marine omega-3 fatty acids on serum systemic and vascular inflammation markers and oxidative stress in hemodialysis patients.

BACKGROUND AND AIMS: High concentrations of serum inflammation markers, especially vascular inflammation markers, are an important risk factor for cardiovascular diseases in hemodialysis patients. The present study was designed to investigate the effects of marine omega-3 fatty acids on serum systemic and vascular inflammation markers and oxidative stress in hemodialysis patients. METHODS: Thirty-four hemodialysis patients were randomly assigned to either the marine omega-3 fatty acid or the placebo group. Patients in the omega-3 fatty acid group received 2,080 mg marine omega-3 fatty acids daily for 10 weeks, whereas the placebo group received a corresponding placebo.At baseline and the end of week 10, 5 ml blood was collected after a 12- to 14-hour fast. RESULTS: Mean serum soluble intercellular adhesion molecule type 1 (sICAM-1) decreased significantly in the omega-3 fatty acid group at the end of week 10 compared to baseline (p < 0.05) and this reduction was significant in comparison with the placebo group (p < 0.05). No significant differences were observed between the two groups in mean changes in serum soluble vascular cell adhesion molecule type 1, sE-selectin, sP-selectin, C-reactive protein, interleukin-6, tumor necrosis factor-α, malondialdehyde and total antioxidant capacity. CONCLUSION: The results of the present study indicate that marine omega-3 fatty acids can reduce serum sICAM-1, a risk factor for cardiovascular diseases, but it has no effect on serum systemic inflammation markers and oxidative stress in hemodialysis patients.

Effects of soy consumption on oxidative stress, blood homocysteine, coagulation factors, and phosphorus in peritoneal dialysis patients.

OBJECTIVE: We studied the effects of soy consumption on oxidative stress, blood homocysteine, coagulation factors, and phosphorus in peritoneal dialysis patients. DESIGN: This was an unblinded, randomized clinical trial. SETTING: This study involved peritoneal dialysis centers in Tehran, Iran. PATIENTS: We included 40 peritoneal dialysis patients (20 males and 20 females). INTERVENTION: Peritoneal dialysis patients were randomly assigned to either a soy or control group. Patients in the soy group received 28 g/day textured soy flour (containing 14 g of soy protein) for 8 weeks, whereas patients in the control group received their usual diet, without any soy. MAIN OUTCOME MEASURES: Blood oxidized low-density lipoprotein (ox-LDL), homocysteine, phosphorus, fibrinogen concentrations, and the activities of coagulation factors VII, IX, and X were measured at baseline and at the end of week 8 of the study. RESULTS: The percentage of plasma coagulation factor IX activity decreased significantly by 17% in the soy group at the end of week 8 compared with baseline (P < .01), and the reduction was significant compared with the control group (P < .05). There were no significant differences between the two groups in mean changes of blood ox-LDL, homocysteine, phosphorus, fibrinogen concentrations, and the activities of coagulation factors VII and X. CONCLUSION: Soy consumption reduces plasma coagulation factor IX activity, which is a risk factor for thrombosis in peritoneal dialysis patients.

Effect of flaxseed oil on serum systemic and vascular inflammation markers and oxidative stress in hemodialysis patients: a randomized controlled trial.

PURPOSE: The aim of this study was to investigate the effects of flaxseed oil consumption on serum systemic and vascular inflammation markers, and oxidative stress in hemodialysis (HD) patients. METHODS: In this randomized, double-blind, clinical trial, 34 HD patients were randomly assigned to either the flaxseed oil or the control group. The patients in the flaxseed oil group received 6 g/day flaxseed oil for 8 week, whereas the control group received 6 g/day medium-chain triglycerides (MCT) oil. At baseline and the end of week 8, serum concentrations of high-sensitive C-reactive protein (hs-CRP), soluble intercellular adhesion molecule type 1 (sICAM-1), soluble vascular cell adhesion molecule type 1 (sVCAM-1), sE-selectin, and malondialdehyde (MDA) were measured after a 12- to 14-h fast. RESULTS: Serum hs-CRP, a systemic inflammation marker, and sVCAM-1, a vascular inflammation marker, reduced significantly in the flaxseed oil group at the end of week 8 compared to baseline (P < 0.05), and the reductions were significant in comparison with the MCT oil group (P < 0.05). There were no significant differences between the two groups in mean changes in serum sICAM-1, sE-selectin, and MDA. CONCLUSION: This study indicates that daily consumption of 6 g flaxseed oil reduces serum hs-CRP and sVCAM-1, which are two risk factors for CVD. Therefore, the inclusion of flaxseed oil in the usual diet of HD patients can be considered as a strategy for reducing CVD risk factors.

Comparison of various scoring methods for the diagnosis of protein-energy wasting in hemodialysis patients.

PURPOSE: The present study was designed to determine the cutoff points for the diagnosis of mild-to-moderate and severe protein-energy wasting (PEW) based on dialysis malnutrition score (DMS) and malnutrition inflammation score (MIS), and the sensitivity, specificity, accuracy, area under receiver operating characteristic (ROC) curve, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR(+)) and negative likelihood ratio (LR(-)) of DMS and MIS in comparison with subjective global assessment (SGA) in hemodialysis (HD) patients. METHODS: In this study, 291 HD patients were randomly selected from among 2,302 adult HD patients in Tehran hemodialysis centers. The PEW in these patients was determined by SGA, DMS and MIS. RESULTS: According to the cutoff points derived from the area under ROC curves, scores of 7-13 for DMS represented normal status or without PEW; 14-23, mild-to-moderate PEW; and 24-35, severe PEW. For MIS, scores of 0-7 represented normal status or without PEW; 8-18, mild-to-moderate PEW; and 19-30, severe PEW. In comparison with SGA, the sensitivity, specificity, accuracy, area under ROC curve, PPV, NPV, LR(+) and LR(-) of DMS were 94 %, 88 %, 92 %, 97 %, 93 %, 92 %, 7.8 and 0.07, respectively. Those of MIS were 87 %, 96 %, 91 %, 97 %, 97 %, 83 %, 22.0 and 0.13 in comparison with SGA, respectively. CONCLUSION: The results of the present study indicate that the DMS and MIS are almost similar to SGA for identifying PEW in HD patients, but it seems that the DMS is a more appropriate alternative tool for SGA in hospital routine assessments.