The Effect of Polyphenol-Rich Interventions on Cardiovascular Risk Factors in Haemodialysis: A Systematic Review and Meta-Analysis
School of Allied Health, La Trobe University, Bundoora, VIC 3086, Australia
Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia
Author to whom correspondence should be addressed.
Received: 11 October 2017 / Revised: 4 December 2017 / Accepted: 6 December 2017 / Published: 11 December 2017
End-stage kidney disease is a strong risk factor for cardiovascular-specific mortality. Polyphenol-rich interventions may attenuate cardiovascular disease risk factors; however, this has not been systematically evaluated in the hemodialysis population. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the following databases were searched: Cochrane Library (http://www.cochranelibrary.com/
), MEDLINE (https://health.ebsco.com/products/medline-with-full-text
), Embase (https://www.elsevier.com/solutions/embase-biomedical-research
), and CINAHL (https://www.ebscohost.com/nursing/products/cinahl-databases/cinahl-complete
). Meta-analyses were conducted for measures of lipid profile, inflammation, oxidative stress, and blood pressure. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias tool and quality of the body of evidence was assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. Twelve studies were included for review. Polyphenol-rich interventions included soy, cocoa, pomegranate, grape, and turmeric. Polyphenol-rich interventions significantly improved diastolic blood pressure (Mean Difference (MD) −5.62 mmHg (95% Confidence Interval (CI) −8.47, −2.78); I2
= 2%; p
= 0.0001), triglyceride levels (MD −26.52 mg/dL (95% CI −47.22, −5.83); I2
= 57%; p
= 0.01), and myeloperoxidase (MD −90.10 (95% CI −135.84, −44.36); I2
= 0%; p
= 0.0001). Included studies generally had low or unclear risks of bias. The results of this review provide preliminary support for the use of polyphenol-rich interventions for improving cardiovascular risk markers in haemodialysis patients. Due to the limited number of studies for individual polyphenol interventions, further studies are required to provide recommendations regarding individual polyphenol intervention and dose.
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MDPI and ACS Style
Marx, W.; Kelly, J.; Marshall, S.; Nakos, S.; Campbell, K.; Itsiopoulos, C. The Effect of Polyphenol-Rich Interventions on Cardiovascular Risk Factors in Haemodialysis: A Systematic Review and Meta-Analysis. Nutrients 2017, 9, 1345.
Marx W, Kelly J, Marshall S, Nakos S, Campbell K, Itsiopoulos C. The Effect of Polyphenol-Rich Interventions on Cardiovascular Risk Factors in Haemodialysis: A Systematic Review and Meta-Analysis. Nutrients. 2017; 9(12):1345.
Marx, Wolfgang; Kelly, Jaimon; Marshall, Skye; Nakos, Stacey; Campbell, Katrina; Itsiopoulos, Catherine. 2017. "The Effect of Polyphenol-Rich Interventions on Cardiovascular Risk Factors in Haemodialysis: A Systematic Review and Meta-Analysis." Nutrients 9, no. 12: 1345.
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