Renal failure-kidney failure i-sfikat klayot and G’dilan[milk thistle]
BackgroundThe incidence of accelerated atherosclerosis among patients on hemodialysis is very high and oxidative stress is a potentially major contributor to their morbidity and mortality.ObjectiveTo evaluate the effects of Silymarin and/or vitamin E on oxidative stress markers and hemoglobin level in patients on hemodialysis.MethodsEighty 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.ResultsCombination 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.ConclusionsOral 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.