Background The incidence of accelerated atherosclerosis among patients on hemodialysis is very high and oxidative stress is a potentially major contributor to their morbidity and mortality. Objective To evaluate the effects of Silymarin and/or vitamin E on oxidative stress markers and hemoglobin level in patients on hemodialysis. Methods Eighty patients on hemodialysis were randomized into 4 groups: Group 1 received Silymarin 140 mg 3 times daily; Group 2 received Vitamin E 400 IU/day; Group 3 received Silymarin 140 mg 3 times daily and Vitamin E 400 IU/day; Group 4 was the control. Samples were obtained at baseline and on day 21 for measurement of malondialdehyde (MDA), RBC glutathione peroxidase (GPX), and hemoglobin. Results Combination of Silymarin and vitamin E led to a reduction in the MDA levels (7.84±1.84 vs. 9.20±2.74 nmol/ml; p=0.008). There was a significant increase in RBC GPX levels in all treatment groups compared to controls after 3 weeks. This was more pronounced in the group receiving combination compared to vitamin E or the control group (5.78±3.51, 4.22±1.63, and 3.16±1.89 Iu/gr-Hb respectively; p<0.001). There was also a significant increase in mean hemoglobin of all treatment groups compared to control. Conclusions Oral supplementation with Silymarin and vitamin E leads to reduction in MDA, increase in RBC GPX and increase in hemoglobin levels in patients with ESRD. Studies with larger sample sizes and longer follow-up are required to investigate the effect of Silymarin on cardiovascular outcomes, and erythropoietin requirement.

In this cross-sectional study, selenium (Se) levels in the sera of 35 hemodialysis (HD) patients and 34 patients undergoing continuous ambulatory peritoneal dialysis (CAPD) for more than 3 months were compared with the serum Se levels of 34 healthy volunteers. The observed Se levels of 100.8 ± 51.9 µg/L in the sera of the HD patients and of 65.5 ± 32.1 µg/L in the sera of the CAPD patients were significantly lower than the 134.9 ± 81.2 µg/L of the controls, with p = 0.002 and 0.02, respectively. Furthermore, the Se levels were significantly higher in the HD rather than the CAPD patients (p = 0.01). In the spent dialysate effluent fluid of 32 of the CAPD patients Se was undetectable, in the remaining two CAPD patients the Se levels were 1.9 and 4.6μg/l, respectively. The low Se levels of HD and CAPD patients as compared to healthy persons are attributed to diminished Se retention due to chronic oxidative stress.

No abstract