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

Research output: Contribution to conferencePresentationResearch

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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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Polyphenols
Renal Dialysis
Meta-Analysis
Blood Pressure
Punicaceae
Lipids
Curcuma
Sudden Cardiac Death
Vitis
Random Allocation
MEDLINE
Powders
Peroxidase
Libraries
Chronic Kidney Failure
Oxidative Stress
Hemodynamics
Databases
Hypertension
Inflammation

Cite this

Kelly, J. T., Marshall, S., Nakos, S., Itsiopoulos, C., & Marx, W. (2017). The effect of polyphenols on cardiovascular risk factors in haemodialysis: a systematic review and meta-analysis. 31. 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.
Kelly, Jaimon T ; Marshall, Skye ; Nakos, Stacey ; Itsiopoulos, Catherine ; Marx, Wolfgang. / The effect of polyphenols on cardiovascular risk factors in haemodialysis: a systematic review and meta-analysis. 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.
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title = "The effect of polyphenols on cardiovascular risk factors in haemodialysis: a systematic review and meta-analysis",
abstract = "Background: End-stage kidney disease is a major health burdenworldwide and is a strong risk factor for sudden cardiac death.Polyphenol supplementation has been suggested to reducecardiovascular risk factors in haemodialysis patients. The aimof this systematic review was to pool and evaluate the currentevidence for polyphenol interventions for cardiovascular riskreduction 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, oxidativestress, and blood pressure. Risk of bias was assessed usingthe Cochrane Collaboration Risk of Bias tool and quality of thebody of evidence assessed by the GRADE methodology.Results: Twelve studies were included which utilised thepolyphenol-rich supplements soy, cocoa, pomegranate,grape, and turmeric in powder or juice form. Risk of biasacross studies was mostly low; though randomisation andallocation was poorly described in most studies. Polyphenolinterventions significantly improved diastolic blood pressure(MD -5.62mmHg [95{\%} CI -8.47, -2.78]; I2=2{\%}; p=0.0001; n=4studies; n=245 participants; GRADE: moderate), triglyceridelevels (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=126participants; GRADE: high). Improvements in other measuresof haemodynamics and lipid profiles were significant withlarge effect sizes in sub-samples with hypertension andhypercholesterolaemia respectively (not pooled).Conclusions: The results suggest polyphenol-richsupplementation may improve cardiovascular risk markersin haemodialysis patients, especially those with existingcardiovascular disease. Further studies of sufficientduration are required to establish efficacy and allow forrecommendation of particular polyphenol types and dosages.",
author = "Kelly, {Jaimon T} and Skye Marshall and Stacey Nakos and Catherine Itsiopoulos and Wolfgang Marx",
year = "2017",
language = "English",
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Kelly, JT, Marshall, S, Nakos, S, Itsiopoulos, C & Marx, W 2017, 'The effect of polyphenols on cardiovascular risk factors in haemodialysis: a systematic review and meta-analysis' 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia, 16/11/17 - 18/11/17, pp. 31.

The effect of polyphenols on cardiovascular risk factors in haemodialysis: a systematic review and meta-analysis. / Kelly, Jaimon T; Marshall, Skye; Nakos, Stacey; Itsiopoulos, Catherine; Marx, Wolfgang.

2017. 31 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.

Research output: Contribution to conferencePresentationResearch

TY - CONF

T1 - The effect of polyphenols on cardiovascular risk factors in haemodialysis: a systematic review and meta-analysis

AU - Kelly, Jaimon T

AU - Marshall, Skye

AU - Nakos, Stacey

AU - Itsiopoulos, Catherine

AU - Marx, Wolfgang

PY - 2017

Y1 - 2017

N2 - Background: End-stage kidney disease is a major health burdenworldwide and is a strong risk factor for sudden cardiac death.Polyphenol supplementation has been suggested to reducecardiovascular risk factors in haemodialysis patients. The aimof this systematic review was to pool and evaluate the currentevidence for polyphenol interventions for cardiovascular riskreduction 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, oxidativestress, and blood pressure. Risk of bias was assessed usingthe Cochrane Collaboration Risk of Bias tool and quality of thebody of evidence assessed by the GRADE methodology.Results: Twelve studies were included which utilised thepolyphenol-rich supplements soy, cocoa, pomegranate,grape, and turmeric in powder or juice form. Risk of biasacross studies was mostly low; though randomisation andallocation was poorly described in most studies. Polyphenolinterventions significantly improved diastolic blood pressure(MD -5.62mmHg [95% CI -8.47, -2.78]; I2=2%; p=0.0001; n=4studies; n=245 participants; GRADE: moderate), triglyceridelevels (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=126participants; GRADE: high). Improvements in other measuresof haemodynamics and lipid profiles were significant withlarge effect sizes in sub-samples with hypertension andhypercholesterolaemia respectively (not pooled).Conclusions: The results suggest polyphenol-richsupplementation may improve cardiovascular risk markersin haemodialysis patients, especially those with existingcardiovascular disease. Further studies of sufficientduration are required to establish efficacy and allow forrecommendation of particular polyphenol types and dosages.

AB - Background: End-stage kidney disease is a major health burdenworldwide and is a strong risk factor for sudden cardiac death.Polyphenol supplementation has been suggested to reducecardiovascular risk factors in haemodialysis patients. The aimof this systematic review was to pool and evaluate the currentevidence for polyphenol interventions for cardiovascular riskreduction 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, oxidativestress, and blood pressure. Risk of bias was assessed usingthe Cochrane Collaboration Risk of Bias tool and quality of thebody of evidence assessed by the GRADE methodology.Results: Twelve studies were included which utilised thepolyphenol-rich supplements soy, cocoa, pomegranate,grape, and turmeric in powder or juice form. Risk of biasacross studies was mostly low; though randomisation andallocation was poorly described in most studies. Polyphenolinterventions significantly improved diastolic blood pressure(MD -5.62mmHg [95% CI -8.47, -2.78]; I2=2%; p=0.0001; n=4studies; n=245 participants; GRADE: moderate), triglyceridelevels (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=126participants; GRADE: high). Improvements in other measuresof haemodynamics and lipid profiles were significant withlarge effect sizes in sub-samples with hypertension andhypercholesterolaemia respectively (not pooled).Conclusions: The results suggest polyphenol-richsupplementation may improve cardiovascular risk markersin haemodialysis patients, especially those with existingcardiovascular disease. Further studies of sufficientduration are required to establish efficacy and allow forrecommendation of particular polyphenol types and dosages.

M3 - Presentation

SP - 31

ER -

Kelly JT, Marshall S, Nakos S, Itsiopoulos C, Marx W. The effect of polyphenols on cardiovascular risk factors in haemodialysis: a systematic review and meta-analysis. 2017. 43rd Annual Scientific Meeting of the Australasian Society for Parenteral and Enteral Nutrition, Gold Coast, Australia.