Pumpkin Seed Oil as a Nutraceutical for Hemodialysis Patients

Chronic systemic inflammation is a cornerstone of hemodialysis pathophysiology, driven byuremic toxin retention, oxidative stress, endotoxemia, and repeated exposure tobioincompatible dialysis membranes, which activate NF‐κB and STAT signaling and sustainelevated IL‐6 and CRP. These biomarkers are independent predictors of cardiovascular andall‐cause mortality, and contribute to the malnutrition‐inflammation complex syndrome(MICS) that affects a substantial proportion of dialysis patients. sVCAM‐1 acts as amechanistic bridge between the uremic milieu and accelerated atherosclerosis, mediatingmonocyte adhesion to the arterial intima and serving as an independent predictor ofcardiovascular mortality in this population.No pharmacological agent is currently routinely or universally prescribed to specificallytarget inflammation in hemodialysis patients; existing options (e.g., anti‐IL‐6 agents,statins, pentoxifylline, nutraceuticals such as curcumin, omega‐3 fatty acids, andvitamin E) show variable biomarker reductions but have not been widely incorporated intostandard practice. Pumpkin seed oil has shown anti‐inflammatory and antioxidant effectsin animal and in vitro studies, including suppression of IL‐1β, IL‐6, TNF‐α, and COX‐2,with effects in some models comparable to NSAIDs. Vitamin E, a major constituent ofpumpkin seed oil, has separately been shown to reduce circulating sVCAM‐1 in hemodialysispatients via suppression of oxidative stress. However, to the investigators' knowledge,no prior human study has directly examined the impact of pumpkin seed oil on IL‐6 and CRPin hemodialysis patients, and no study has investigated its effect on sVCAM‐1specifically in this population.This study addresses that gap by evaluating the effect of 1000 mg/day oral pumpkin seedoil for 3 months, in addition to usual hemodialysis care, on inflammatory (IL‐6, hsCRP,sVCAM‐1), oxidative stress (MDA, SOD), and lipid biomarkers, compared with a usual‐carecontrol group, in patients with ESRD on maintenance hemodialysis at the HemodialysisCenter, Al‐Karama Teaching Hospital, Iraq.