Turmeric supplementation with piperine is more effective than turmeric alone in attenuating oxidative stress and inflammation in hemodialysis patients: A randomized, double-blind clinical trial

Purpose: Turmeric has renop rotective effects that can act to reduce oxidative stress and inflammation in he-modialysis (HD) patients. Piperine has been indicated as a bioavailability enhancer of turmeric and consequently of its biological effects. However, data on the efficacy of the turmeric/piperine combination in HD patients are limited. We aimed to verify whether turmeric supplementation in combination with piperine has a superior effect to turmeric alone in increasing antioxidant capacity and reducing oxidative stress and inflammation in HD patients.Methods: This randomized, double-blind clinical trial was conducted in HD patients (age 20-75 years). Patients were supplemented with turmeric (3 g/day) or turmeric/piperine (3 g turmeric + 2 mg piperine/day) for 12 weeks. Malondialdehyde (MDA), antioxidant enzymes catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), high-sensitivity C-reactive protein (hs-CRP), and ferritin were evaluated at baseline and the end of the study.Results: There was a reduction in the MDA and ferritin levels in the turmeric/piperine group and in the com-parison between groups at the end of the study [MDA:-0.08(-0.14/0.01) nmol/mL versus-0.003(-0.10/0.26) nmol/mL, p = 0.003; ferritin:-193.80 +/- 157.29 mg/mL versus 51.99 +/- 293.25 mg/mL, p = 0.018]. In addition, GPx activity reduced in the turmeric group (p = 0.029). No changes were observed for CAT, GR, and hs-CRP.Conclusion: Turmeric plus piperine was superior to turmeric alone in decreasing MDA and ferritin levels. The use of a combination of turmeric and piperine as a dietary intervention may be beneficial for modulating the status oxidative and inflammation in HD patients.Brazilian Registry of Clinical Trials Number: RBR-2t5zpd; Registration Date: May 2, 2018.