Immune responses and inflammation are major risk factors for mortality in patients with end-stage renal disease (ESRD). Increased oxidative stress is a common feature of ESRD, and it has been speculated that it is interrelated to inflammation. In many studies it has been proved that red grape seed extract (RGSE) provides an antioxidant efficacy. Objectives: The aim of this study was to investigate the anti-inflammatory effects of RGSE in hemodialysis patients. Patients and Methods: Thirty hemodialysis individuals were divided into two groups that received either 200 mg/day of the RGSE or placebo for one month. Mean ± SD of age of patients was 58.5 ± 10.5 years. Duration of dialysis was 4 ± 3.4 years and 27 patients were male and 3 patients were female. After a 2-week washout period, the groups were crossed over for another one month. Markers of inflammation, lipid profiles and blood factors were measured at baseline after intervention with RGSE or placebo. Results: Our results showed that RGSE consumption could not make statistically significant changes in markers of inflammation, lipid profiles and blood factors in hemodialysis patients. Conclusion: Although RGSE could not improve markers of inflammation, lipid profiles and blood factors in hemodialysis subjects over a 1 month period. However, this result may be due to short period of treatment or low dose of RGSE. Further studies need to clear these contradictions.

BackgroundGarlic can be considered as a useful natural herb in inhibition of inflammation. The aim of this study was to assess the effectiveness of garlic extract in lowering inflammatory markers in peritoneal dialysis (PD) patients.MethodsIn this parallel-designed double blind randomized clinical trial, 42 PD patients at the Shafa dialysis center, Tehran in 2017 were included. The primary outcome in this study was systemic inflammation which was evaluated by measuring the concentrations of IL-6 and CRP and ESR in serum.ResultsBaseline versus after-intervention median (IQR) of IL-6 (pg/ml), CRP (mg/L) and mean ± SD of ESR (mm) in garlic and placebo groups was 2.2 (0.8, 6.4) versus 0.7 (0.6, 1.2) (p <  0.001) and 2.0 (0.8, 2.1) versus 0.6 (0.6, 0.8) (p = 0.002), 13.0 (5.0, 14.0) versus 2.0 (1.0, 9.0) (p <  0.001) and 7.0 (2.0, 10.0) versus 6.0 (3.7, 7.5) (p = 0.547) and 35.4 ± 21.7 versus 50.7 ± 28.5 (p = 0.021) and 46.0 ± 26.0 versus 45.3 ± 22.3 (p = 0.797). Median (IQR) of Percentage Before-After change in CRP was − 71.4%(− 85.7, − 42.9%) and − 20.0%(− 30.0, 114.3%) in garlic and placebo group respectively. The Mann-Whitney U test indicated this difference is statistically significant (p <  0.001).ConclusionThe results imply that administrating 400 mg of standardized garlic extract twice a day for 8 weeks resulted in a significant reduction in IL-6, CRP and ESR. Since inflammatory state can be a serious life threatening condition in PD patients, we suggest prescribing this safe and well-tolerated natural substance to attenuate the inflammatory state in these patients. However, assessment of these effects in a larger randomized trial is strongly recommended (IRCTID: IRCT2017072535305N1, 2017-10-16).

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Background. Inflammation plays a prominent role in the deteriorating cardiovascular risk of hemodialysis patients. Utilization of herbal remedies, especially garlic extract, in these patients has resulted in promising improvement in lipid profile, inflammation, and cardiovascular markers. Purpose. In this survey, we aimed to determine the effects of oral administration of Allium sativum powder on lipid profile, inflammation, and cardiovascular markers among hemodialysis patients. Methods. In this interventional double-blinded randomized crossover study, 70 patients were enrolled and assigned in two groups. Each group received 300 mg of garlic powder BID or placebo for eight weeks; after a six-week wash-out period, the agents were switched between two groups so that the group who received garlic powder in the first eight weeks received placebo for the second eight weeks, and vice versa. Venous blood samples were obtained in baseline, wash-out period, and at the end of study. Following obtaining laboratory data, BUN, creatinine, Na, K, Ca, Ph, homocysteine, and lipid profile were compared. Results. No significant differences were shown at baselines of outcomes between the garlic and placebo group ( p value>0.05). However, there was a significant decrease in absolute values of OXLDL (mean placebo = 979.63, mean garlic = 676.54; p value<0.001) and HCY (mean placebo = 36.54, mean garlic = 27.78; p value<0.001). In addition, significant treatment differences were seen in change values of Ca (placebo = 1.17, garlic = 0.21; p value = 0.006), TG (placebo = −6.71, garlic = -24.14; p value = 0.014), OXLDL (placebo = −281.30, garlic = -699.78; p value<0.001), and HCY (placebo = −0.24, garlic = −6.68; p value<0.001). Conclusion. In this study, Allium sativum powder demonstrated efficacy in lipid profile improvement and renal protective effects among hemodialysis patients.