Pomegranate juice intake attenuates the increase in oxidative stress induced by intravenous iron during hemodialysis

Lilach Shema-Didi, Batya Kristal, Liora Ore, Galina Shapiro, Ronit Geron, Shifra Sela

Research output: Contribution to journalArticlepeer-review


The hemodialysis (HD) procedure induces oxidative stress (OS), which is further aggravated by intravenous (IV) iron administration, aimed at correcting anemia of patients with HD. We have recently shown that 1 year of pomegranate juice (PJ) intake attenuated OS and inflammation in patients with HD. In the current study, we hypothesized that a single dose of PJ can attenuate the enhanced OS and inflammation induced by both the dialysis procedure and IV iron administration during HD session. Twenty-seven patients with HD were randomized to receive PJ or placebo during 1 dialysis session with IV iron. Blood samples were drawn before and after the session to asses OS biomarkers such as advanced oxidation protein products and myeloperoxidase (MPO), whereas polymorphonuclear leukocyte (PMNL) counts served as an indirect measure of inflammation. At the end of the dialysis session, an increase in advanced oxidation protein products and MPO levels as well as a decrease in PMNLs counts were observed in the placebo group, whereas no significant changes occurred in the PJ group. The postdialysis increase in MPO levels in the placebo group is a direct result of PMNL degranulation, associated with postdialysis decrease in PMNL counts. Degranulation of PMNLs leads to the release of other cell moieties, such as inflammatory mediators and proteases that enhance inflammation. We conclude that PJ intake attenuated the increase in systemic OS and inflammation induced by IV iron administration during the dialysis session. These beneficial effects illuminate the previously observed attenuation in OS and inflammation in patients with HD on prolonged PJ intake.

Original languageEnglish
Pages (from-to)442-446
Number of pages5
JournalNutrition Research
Issue number6
StatePublished - Jun 2013

Bibliographical note

Funding Information:
This study was supported by Grant No. 6186 from the Chief Scientist Office of the Ministry of Health, Israel ; Grant No. 2012255 from Jess & Midred Fisher Family Cardiology Research Fund, Office of the Executive Vice President for Research, Technion, Israel ; and Iscar Ltd. The authors are indebted to Hadya Sabik (BSc) from the Research Laboratory, Western Galilee Hospital, for the biomarker analysis.


  • Hemodialysis
  • Iron
  • Oxidative stress
  • Pomegranate juice

ASJC Scopus subject areas

  • Endocrinology
  • Nutrition and Dietetics
  • Endocrinology, Diabetes and Metabolism


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