Effectiveness of Garlic Extract (Allium sativum) to Reduce Level of Malondialdehyde Serum and Improve Quality of Life in Patients with Chronic Hemodialysis: A Randomized Double-Blind Placebo-Controlled Trial

Abstract

Introduction. Study reported that malondialdehyde (MDA) levels as an in vivo marker of oxidative stress were increased in patients undergoing hemodialysis. Antioxidants allicin compounds contained in garlic (Allium sativum) are known to have antioxidant activity by inducing antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT) and inhibiting prooxidant enzymes (nitric oxide synthase, xanthine, NADPH oxidase, and cyclooxygenase). This study aimed to investigate the effectiveness of Allium sativum to reduce level of MDA serum and improve quality of life in patients with chronic hemodialysis. Methods. This study was a crossover randomized double-blind placebo-controlled trial. The subjects were 40 chronic kidney disease (CKD) stage 5 patients with chronic hemodialysis (HD). Subjects were randomly divided into 2 groups, namely the group that received 1,000 mg of garlic extract per day (2 x 500 mg) for 6 weeks and the group that received a placebo, which was then carried out during a washing period for 2 weeks and then the two groups were crossover. Each group measured the levels of serum MDA before and after treatment, also fill in kidney disease quality of life (KDQOL) SF-36 questionnaire. Results. Out of 40 subjects, most of them were male (57.5%) with median of age of 48.6 (range 26-59) years. It was found that serum MDA levels before and after garlic extract administration were 2.423 (SD 0.236) nmol/l and 1.649 (SD 0.26) nmol/l (p<0,001) with a mean change of -0.782 (SD 0.735) nmol/l. Statistical analysis showed a significance difference of MDA serum between the two groups. There was significant improvement in quality of life before and after garlic extract administration from 57.81 (SD 16.95) to 67.62 (SD 13.61) with a mean change of 9.81 (SD 3.34). But there was no significant difference between quality of life and MDA serum. Conclusion. There is effectiveness of garlic extract to decrease serum MDA and improve the quality of life in patients with CKD stage 5 using chronic HD at Mohammad Hoesin Hospital, Palembang.