Itsiopoulos, Catherine

Kelly, Jaimon T

Marshall, Skye

Marx, Wolfgang

Nakos, Stacey

English

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.<br/

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

https://pure.bond.edu.au/ws/files/30102680/AuSPEN_Conference_Program_and_Abstracts.pdf

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

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