Comparative effects of silymarin and vitamin E supplementation on oxidative stress markers, and hemoglobin levels among patients on hemodialysis.

Background: The incidence of accelerated atherosclerosis among patients on hemodialysis is very high and oxidative stress (OS) is a potentially major contributor to their morbidity and mortality. Objective: To evaluate the effects of Silymarin and//or vitamin E on OS markers and hemoglobin levels in patients on hemodialysis. Methods: Eighty patients on hemodialysis were randomized into four 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; and Group 4 was the control. Samples were obtained at baseline and on day 21 for measurement of malondialdehyde (MDA), red blood cell (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 with controls after 3 weeks. This was more pronounced in the group receiving combination compared with the group receiving vitamin E or the control group (5.78 +/-+/- 3.51, 4.22 +/-+/- 1.63, and 3.16 +/-+/- 1.89 IU//grHb, respectively; p < 0.001). There was also a significant increase in mean hemoglobin of all treatment groups compared with the 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 end-stage renal disease. Studies with larger sample sizes and longer follow-up are required to investigate the effect of silymarin on cardiovascular outcomes and erythropoietin requirement.更多