The effect of polyphenols on cardiovascular risk factors in haemodialysis: a systematic review and meta-analysis

Jaimon T Kelly, Skye Marshall, Stacey Nakos, Catherine Itsiopoulos, Wolfgang Marx

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Abstract

Background: End-stage kidney disease is a major health burden
worldwide and is a strong risk factor for sudden cardiac death.
Polyphenol supplementation has been suggested to reduce
cardiovascular risk factors in haemodialysis patients. The aim
of this systematic review was to pool and evaluate the current
evidence for polyphenol interventions for cardiovascular risk
reduction in haemodialysis patients.
Methods: The Cochrane Library, MEDLINE (vis Scopus),
Embase, and CINAHL were searched for double-blind placebocontrolled randomised trials up until 29 June 2017. PhenolExplorer 3.6 database was used to inform known polyphenolrich interventions. Treatment effect was quantified by metaanalysis for measures of lipid profile, inflammation, oxidative
stress, and blood pressure. Risk of bias was assessed using
the Cochrane Collaboration Risk of Bias tool and quality of the
body of evidence assessed by the GRADE methodology.
Results: Twelve studies were included which utilised the
polyphenol-rich supplements soy, cocoa, pomegranate,
grape, and turmeric in powder or juice form. Risk of bias
across studies was mostly low; though randomisation and
allocation was poorly described in most studies. Polyphenol
interventions significantly improved diastolic blood pressure
(MD -5.62mmHg [95% CI -8.47, -2.78]; I2=2%; p=0.0001; n=4
studies; n=245 participants; GRADE: moderate), triglyceride
levels (MD -26.52mg/dL [95% CI -47.22, -5.83]; I2=57%;
p=0.01; n=4 studies; n=191 participants; GRADE: very low),
and oxidative stress (myeloperoxidase) (SMD -90.1 [95%
CI -135.8, -44.4]; I2=0%; p=0.0001; n=2 studies; n=126
participants; GRADE: high). Improvements in other measures
of haemodynamics and lipid profiles were significant with
large effect sizes in sub-samples with hypertension and
hypercholesterolaemia respectively (not pooled).
Conclusions: The results suggest polyphenol-rich
supplementation may improve cardiovascular risk markers
in haemodialysis patients, especially those with existing
cardiovascular disease. Further studies of sufficient
duration are required to establish efficacy and allow for
recommendation of particular polyphenol types and dosages.
Original languageEnglish
Pages31
Publication statusPublished - 2017
Event43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition: Collaboration in Clinical Nutrition – Evidence Based Nutrition for Improving Patient Outcomes - Royal Pines Conference Centre, Gold Coast, Australia
Duration: 16 Nov 201718 Nov 2017
Conference number: 43rd

Conference

Conference43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition
Abbreviated titleAuSPEN 2017
CountryAustralia
CityGold Coast
Period16/11/1718/11/17

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