Abstract
Background Increased oxidative stress play an important role in the risk of cardiovascular disease, mortality, and mortality patients undergoing dialysis. Nasturtium officinale (watercress) contains numerous phytochemical compounds that act as an antioxidant by preventing oxidative damage to biomolecules. Therefore, this research aimed to explore the effect of the ethanolic extract of Nasturtium officinale (EENO) on antioxidant and biochemical markers of hemodialysis patients. Methods In this double-blind, placebo-controlled trial, 46 hemodialysis patients were randomly recruited to consume either 500 mg/day EENO (n = 23) or placebo capsule (n = 23) for 4 weeks, at Shahid Beheshti Hospital, Yasuj, Iran, in 2019. Biomarkers of oxidative stress including glutathione peroxidase (GPX), superoxide dismutase (SOD), malondialdehyde (MDA), total oxidant status (TOS), total antioxidant capacity (TAC), and total sulfhydryl protein (T-SH) and biochemical parameters such as BUN, Hb, WBC, PLT, Ca, Ph, K, ALB, TChol, TG, LDL, and HDL were evaluated on days 0 and 28. Results The serum levels of MDA and BUN significantly decreased after taking EENO supplementation (P < 0.001); however, SOD activity increased during the same period (P < 0.001). The serum levels of TAC remained constant in the intervention group, while it significantly declined in the placebo group (P < 0.09). The extract also prevented elevation in the serum levels of LDL and TG compared to the placebo group, although it was not statistically significant. Conclusions The data indicated that the consumption of EENO improved some of the antioxidant parameters and minimizes the change in TG and LDL in hemodialysis patients. Therefore, due to the role of these factors in mortality and morbidity of dialysis patients, EENO can improve the condition of dialysis patients. However, more studies with longer intervention times and different doses of EENO are recommended.
Highlights
Chronic kidney disease (CKD) is a clinical syndrome specified by the progressive, slow, and permanent loss of kidney function. is process leads to catabolism, altered electrolyte-water balance, and acid-base balance
Our result showed that the consumption of 500 mg/day of ethanolic extract of Nasturtium officinale (EENO) significantly reduced the serum level of MDA compared to baseline and placebo groups. is finding is in good agreement with a study, which reported that EENO reduced MDA levels in people with physical disabilities [33]
superoxide dismutase (SOD) as an antioxidant enzyme is existent in extracellular fluids and almost all aerobic cells. is enzyme is the first and very important line of defense enzymes against oxidative stress, especially superoxide anion radicals [36]. e data from this present study revealed that the SOD value increased in both EENO supplementation and placebo groups compared to the baseline value, but the increase in the EENO group was greater than that observed in placebo individuals. ese findings confirm the previous results that showed EENO increased the SOD activity in hypercholesterolaemic rats [34]
Summary
Chronic kidney disease (CKD) is a clinical syndrome specified by the progressive, slow, and permanent loss of kidney function. is process leads to catabolism (uremic toxins accumulation), altered electrolyte-water balance, and acid-base balance. Increased oxidative stress in these patients has several major causes; one of them is the loss of antioxidants during dialysis and the interaction between the blood and dialysis membrane [4] Another reason is the bacterial products in dialysis, which directly or indirectly stimulate the secretion of free radicals by neutrophils. Hemodialysis stimulates the immune cells and increases the production of reactive oxygen species, leading to an acute inflammatory reaction and oxidative stress [5]. All of these factors play important roles in the pathogenesis of atherosclerotic CVD. Results. e serum levels of MDA and BUN significantly decreased after taking EENO supplementation (P < 0.001); SOD activity increased during the same period (P < 0.001)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
