Efficacy of Nutritional Interventions on Inflammatory Markers in Haemodialysis Patients: A Systematic Review and Limited Meta-Analysis
Low-grade chronic inflammation is prevalent in patients undergoing haemodialysis (HD) treatment and is linked to the development of premature atherosclerosis and mortality. The non-pharmacological approach to treat inflammation in HD patients through nutritional intervention is well cited. We aimed...
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| Veröffentlicht in: | Nutrients 2018-03, Vol.10 (4), p.397 |
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| creator | Khor, Ban-Hock Narayanan, Sreelakshmi Sankara Sahathevan, Sharmela Gafor, Abdul Halim Abdul Daud, Zulfitri Azuan Mat Khosla, Pramod Sabatino, Alice Fiaccadori, Enrico Chinna, Karuthan Karupaiah, Tilakavati |
| description | Low-grade chronic inflammation is prevalent in patients undergoing haemodialysis (HD) treatment and is linked to the development of premature atherosclerosis and mortality. The non-pharmacological approach to treat inflammation in HD patients through nutritional intervention is well cited. We aimed to assess the efficacy of different nutritional interventions at improving inflammatory outcomes in HD patients, based on markers such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumour necrosis factor-α (TNF-α). We searched PubMed, Cochrane Library, and Embase for randomized controlled trials (RCT) published before June 2017. Inclusion criteria included RCTs on adult patients on maintenance HD treatment with duration of nutritional interventions for a minimum 4 weeks. Risk of bias was assessed using the Jadad score. In total, 46 RCTs experimenting different nutritional interventions were included in the review and categorized into polyphenols rich foods, omega-3 fatty acids, antioxidants, vitamin D, fibres, and probiotics. Meta-analyses indicated significant reduction in CRP levels by omega-3 fatty acids (Random model effect: -0.667 mg/L,
< 0.001) and vitamin E (fixed model effect: -0.257 mg/L,
= 0.005). Evidence for other groups of nutritional interventions was inconclusive. In conclusion, our meta-analysis provided evidence that omega-3 fatty acids and vitamin E could improve inflammatory outcomes in HD patients. |
| doi_str_mv | 10.3390/nu10040397 |
| format | Article |
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< 0.001) and vitamin E (fixed model effect: -0.257 mg/L,
= 0.005). Evidence for other groups of nutritional interventions was inconclusive. In conclusion, our meta-analysis provided evidence that omega-3 fatty acids and vitamin E could improve inflammatory outcomes in HD patients.</description><identifier>ISSN: 2072-6643</identifier><identifier>EISSN: 2072-6643</identifier><identifier>DOI: 10.3390/nu10040397</identifier><identifier>PMID: 29570616</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Antioxidants ; Arteriosclerosis ; Atherosclerosis ; C-reactive protein ; Clinical trials ; Fatty acids ; Fibers ; Hemodialysis ; Inflammation ; Interleukin 6 ; Markers ; Meta-analysis ; Omega-3 fatty acids ; Patients ; Pharmacology ; Polyphenols ; Probiotics ; Proteins ; Review ; Systematic review ; Tocopherol ; Tumor necrosis factor-TNF ; Tumor necrosis factor-α ; Tumors ; Vitamin D ; Vitamin E</subject><ispartof>Nutrients, 2018-03, Vol.10 (4), p.397</ispartof><rights>Copyright MDPI AG 2018</rights><rights>2018 by the authors. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c472t-45112a4f87004f3d5df780d6a03312a7f8bab58d59f978c362601fddd96e10a33</citedby><cites>FETCH-LOGICAL-c472t-45112a4f87004f3d5df780d6a03312a7f8bab58d59f978c362601fddd96e10a33</cites><orcidid>0000-0002-4017-107X ; 0000-0003-2098-7597</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946182/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946182/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29570616$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Khor, Ban-Hock</creatorcontrib><creatorcontrib>Narayanan, Sreelakshmi Sankara</creatorcontrib><creatorcontrib>Sahathevan, Sharmela</creatorcontrib><creatorcontrib>Gafor, Abdul Halim Abdul</creatorcontrib><creatorcontrib>Daud, Zulfitri Azuan Mat</creatorcontrib><creatorcontrib>Khosla, Pramod</creatorcontrib><creatorcontrib>Sabatino, Alice</creatorcontrib><creatorcontrib>Fiaccadori, Enrico</creatorcontrib><creatorcontrib>Chinna, Karuthan</creatorcontrib><creatorcontrib>Karupaiah, Tilakavati</creatorcontrib><title>Efficacy of Nutritional Interventions on Inflammatory Markers in Haemodialysis Patients: A Systematic Review and Limited Meta-Analysis</title><title>Nutrients</title><addtitle>Nutrients</addtitle><description>Low-grade chronic inflammation is prevalent in patients undergoing haemodialysis (HD) treatment and is linked to the development of premature atherosclerosis and mortality. The non-pharmacological approach to treat inflammation in HD patients through nutritional intervention is well cited. We aimed to assess the efficacy of different nutritional interventions at improving inflammatory outcomes in HD patients, based on markers such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumour necrosis factor-α (TNF-α). We searched PubMed, Cochrane Library, and Embase for randomized controlled trials (RCT) published before June 2017. Inclusion criteria included RCTs on adult patients on maintenance HD treatment with duration of nutritional interventions for a minimum 4 weeks. Risk of bias was assessed using the Jadad score. In total, 46 RCTs experimenting different nutritional interventions were included in the review and categorized into polyphenols rich foods, omega-3 fatty acids, antioxidants, vitamin D, fibres, and probiotics. Meta-analyses indicated significant reduction in CRP levels by omega-3 fatty acids (Random model effect: -0.667 mg/L,
< 0.001) and vitamin E (fixed model effect: -0.257 mg/L,
= 0.005). Evidence for other groups of nutritional interventions was inconclusive. In conclusion, our meta-analysis provided evidence that omega-3 fatty acids and vitamin E could improve inflammatory outcomes in HD patients.</description><subject>Antioxidants</subject><subject>Arteriosclerosis</subject><subject>Atherosclerosis</subject><subject>C-reactive protein</subject><subject>Clinical trials</subject><subject>Fatty acids</subject><subject>Fibers</subject><subject>Hemodialysis</subject><subject>Inflammation</subject><subject>Interleukin 6</subject><subject>Markers</subject><subject>Meta-analysis</subject><subject>Omega-3 fatty acids</subject><subject>Patients</subject><subject>Pharmacology</subject><subject>Polyphenols</subject><subject>Probiotics</subject><subject>Proteins</subject><subject>Review</subject><subject>Systematic review</subject><subject>Tocopherol</subject><subject>Tumor necrosis factor-TNF</subject><subject>Tumor necrosis factor-α</subject><subject>Tumors</subject><subject>Vitamin D</subject><subject>Vitamin E</subject><issn>2072-6643</issn><issn>2072-6643</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkctu1DAUhi0EolXbDQ-ALLFBSKG-JHbCAmlUlbbSFBCXtXUmtsElsYvtDMoL8Nx1NKUXvPHlfOf3f_Qj9IKSt5x35NhPlJCa8E4-QfuMSFYJUfOnD8576CilK7IsSaTgz9Ee6xpJBBX76O-pta6HfsbB4o9Tji674GHAFz6buDV-uSYcfHmwA4wj5BBnfAnxl4kJO4_PwYxBOxjm5BL-DNmVpvQOr_DXOWVTGlyPv5itM38weI3XbnTZaHxpMlQrv-s7RM8sDMkc3e4H6PuH028n59X609nFyWpd9bVkuaobShnUtpVlZst1o61siRZAOC8FadsNbJpWN53tZNtzwQShVmvdCUMJcH6A3u90r6fNaHRfrEYY1HV0I8RZBXDqccW7n-pH2KqmqwVtWRF4fSsQw-_JpKxGl3ozDOBNmJJihLaENeXjgr76D70KUywDL1RNpBSML9SbHdXHkFI09s4MJWpJWN0nXOCXD-3fof_y5DfP06LE</recordid><startdate>20180323</startdate><enddate>20180323</enddate><creator>Khor, Ban-Hock</creator><creator>Narayanan, Sreelakshmi Sankara</creator><creator>Sahathevan, Sharmela</creator><creator>Gafor, Abdul Halim Abdul</creator><creator>Daud, Zulfitri Azuan Mat</creator><creator>Khosla, Pramod</creator><creator>Sabatino, Alice</creator><creator>Fiaccadori, Enrico</creator><creator>Chinna, Karuthan</creator><creator>Karupaiah, Tilakavati</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4017-107X</orcidid><orcidid>https://orcid.org/0000-0003-2098-7597</orcidid></search><sort><creationdate>20180323</creationdate><title>Efficacy of Nutritional Interventions on Inflammatory Markers in Haemodialysis Patients: A Systematic Review and Limited Meta-Analysis</title><author>Khor, Ban-Hock ; 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The non-pharmacological approach to treat inflammation in HD patients through nutritional intervention is well cited. We aimed to assess the efficacy of different nutritional interventions at improving inflammatory outcomes in HD patients, based on markers such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumour necrosis factor-α (TNF-α). We searched PubMed, Cochrane Library, and Embase for randomized controlled trials (RCT) published before June 2017. Inclusion criteria included RCTs on adult patients on maintenance HD treatment with duration of nutritional interventions for a minimum 4 weeks. Risk of bias was assessed using the Jadad score. In total, 46 RCTs experimenting different nutritional interventions were included in the review and categorized into polyphenols rich foods, omega-3 fatty acids, antioxidants, vitamin D, fibres, and probiotics. Meta-analyses indicated significant reduction in CRP levels by omega-3 fatty acids (Random model effect: -0.667 mg/L,
< 0.001) and vitamin E (fixed model effect: -0.257 mg/L,
= 0.005). Evidence for other groups of nutritional interventions was inconclusive. In conclusion, our meta-analysis provided evidence that omega-3 fatty acids and vitamin E could improve inflammatory outcomes in HD patients.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>29570616</pmid><doi>10.3390/nu10040397</doi><orcidid>https://orcid.org/0000-0002-4017-107X</orcidid><orcidid>https://orcid.org/0000-0003-2098-7597</orcidid><oa>free_for_read</oa></addata></record> |
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| source | PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Antioxidants Arteriosclerosis Atherosclerosis C-reactive protein Clinical trials Fatty acids Fibers Hemodialysis Inflammation Interleukin 6 Markers Meta-analysis Omega-3 fatty acids Patients Pharmacology Polyphenols Probiotics Proteins Review Systematic review Tocopherol Tumor necrosis factor-TNF Tumor necrosis factor-α Tumors Vitamin D Vitamin E |
| title | Efficacy of Nutritional Interventions on Inflammatory Markers in Haemodialysis Patients: A Systematic Review and Limited Meta-Analysis |
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