The Effects of Curcumin on Inflammatory and Oxidative Stress Biomarkers in Pediatric Patients on Regular Hemodialysis: A Randomized Placebo-controlled Trial

Aim: Curcumin is a Chinese plant known for its anti-inflammatory, antioxidant, and anti-tumour activity.Its efficacy and safety in children with end-stage renal disease (ESRD) have not yet been established.This study aimed to evaluate curcumin's effects on inflammatory and oxidative stress biomarkers in children on regular hemodialysis (HD), and to investigate the effects of curcumin supplementation in children with ESRD undergoing regular HD.Materials and Methods: This randomized, placebo-controlled, double-blind, pilot study was conducted on 28 children with ESRD on regular HD.This study was conducted between March 2022 and December 2022 at a pediatric HD unit.The patients were randomly assigned to either one gram of curcumin (the active group) or a starch-based placebo once a day (the placebo group), with both groups having 14 patients.Patient history, organ function assessment, tumor necrosis factor (TNF) as an inflammatory biomarker, malondialdehyde (MDA) as an oxidative stress factor, and coagulation biomarkers such as prothrombin time, partial thromboplastin time, and international normalized ratio were assessed and followed for 6 months.Results: At 3 months, the curcumin group showed a significant reduction in MDA levels when compared to the placebo group (median 4.97 vs. 13.60 nmoL/mL, p=0.001).TNF- levels had declined significantly within the curcumin group at 6 months (p=0.030).A significant decrease in uric acid levels was also observed at 3 months in the curcumin group (p=0.008).Hemoglobin levels showed a modest but statistically significant increase at 6 months (p=0.0232).No significant changes were noted in high sensitivity C-reactive protein, estimating glomerular filtration rate, creatinine, alanine transaminase, or coagulation parameters when compared to the placebo.Conclusion: Curcumin may have potential benefits in pediatric patients on HD due to its considerable effects in decreasing inflammatory as well as oxidative stress biomarkers.