NCT02974491

Brief Summary

The investigators hypothesized that acute consumption of Fuji apple juice (AJ) could increase the antioxidant status and/or decrease the oxidative stress (OS) biomarkers, without increasing serum biochemical parameters in patients undergoing maintenance hemodialysis (MHD). In this pre-post pilot feasibility study, patients served as their own controls, received 300 and 150 mL AJ immediately after a dialysis section, on different days, with a 3 week-washout period. Blood was collected at the baseline period, after 30 and 60 min of AJ consumption. OS biomarkers (total antioxidant status (TAS), total oxidant status (TOS), ascorbic acid, catalase (CAT), glutathione peroxidase (Gpx), superoxide dismutase (SOD) and reduced glutathione (GSH) and potassium, phosphorus, uric acid, and glucose concentrations were analyzed.

Trial Health

100
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
6

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Aug 2015

Shorter than P25 for not_applicable

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

August 1, 2015

Completed
2 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2015

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 1, 2015

Completed
1.1 years until next milestone

First Submitted

Initial submission to the registry

November 10, 2016

Completed
18 days until next milestone

First Posted

Study publicly available on registry

November 28, 2016

Completed
Last Updated

November 28, 2016

Status Verified

November 1, 2016

Enrollment Period

2 months

First QC Date

November 10, 2016

Last Update Submit

November 22, 2016

Conditions

Keywords

hemodialysisdiabetes mellitusapple juicepotassium

Outcome Measures

Primary Outcomes (11)

  • Measuring oxidative stress biomarkers

    Total antioxidant status (TAS) (mmol/L) and total oxidant status (TOS) (mmol/L) was measured at the baseline period, after 30 and 60 min of acute consumption of 300 and 150 mL of Fuji apple (Malus domestica Borkh) juice. Patients were not fasted for the withdrawal of blood. This measure was taken to prevent discomfort among volunteers. Venous blood samples were collected through aseptic venipuncture on the opposite arm of the arteriovenous fistula by a qualified professional using a vacuum system into heparin or EDTA-containing tubes or tubes without additives according to established standards of clinical and biological safety.

    Change from baseline at 30 and 60 minutes

  • Measuring endogenous antioxidant enzymes

    Catalase (U mg/Hb), glutathione peroxidase (U mg/Hb) and superoxide dismutase (U mg/Hb) was measured at the baseline period, after 30 and 60 min of acute consumption of 300 and 150 mL of Fuji apple (Malus domestica Borkh) juice. Patients were not fasted for the withdrawal of blood. This measure was taken to prevent discomfort among volunteers. Venous blood samples were collected through aseptic venipuncture on the opposite arm of the arteriovenous fistula by a qualified professional using a vacuum system into heparin or EDTA-containing tubes or tubes without additives according to established standards of clinical and biological safety.

    Change from baseline at 30 and 60 minutes

  • Measuring oxidative stress biomarkers

    Ascorbic acid (micromole/L) was measured at the baseline period, after 30 and 60 min of acute consumption of 300 and 150 mL of Fuji apple (Malus domestica Borkh) juice. Patients were not fasted for the withdrawal of blood. This measure was taken to prevent discomfort among volunteers. Venous blood samples were collected through aseptic venipuncture on the opposite arm of the arteriovenous fistula by a qualified professional using a vacuum system into heparin or EDTA-containing tubes or tubes without additives according to established standards of clinical and biological safety.

    Change from baseline at 30 and 60 minutes

  • Measuring oxidative stress biomarkers

    Reduced glutathione (micromole mg/Hb) was measured at the baseline period, after 30 and 60 min of acute consumption of 300 and 150 mL of Fuji apple (Malus domestica Borkh) juice. Patients were not fasted for the withdrawal of blood. This measure was taken to prevent discomfort among volunteers. Venous blood samples were collected through aseptic venipuncture on the opposite arm of the arteriovenous fistula by a qualified professional using a vacuum system into heparin or EDTA-containing tubes or tubes without additives according to established standards of clinical and biological safety.

    Change from baseline at 30 and 60 minutes

  • Measuring serum biochemical parameters

    Potassium (mmol/L), phosphorus (mmol/L) and glucose (mmol/L) was measured at the baseline period, after 30 and 60 min of acute consumption of 300 and 150 mL of Fuji apple (Malus domestica Borkh) juice. Patients were not fasted for the withdrawal of blood. This measure was taken to prevent discomfort among volunteers. Venous blood samples were collected through aseptic venipuncture on the opposite arm of the arteriovenous fistula by a qualified professional using a vacuum system into heparin or EDTA-containing tubes or tubes without additives according to established standards of clinical and biological safety.

    Change from baseline at 30 and 60 minutes

  • Measuring serum biochemical parameters

    Uric acid (micromole/L) was measured at the baseline period, after 30 and 60 min of acute consumption of 300 and 150 mL of Fuji apple (Malus domestica Borkh) juice. Patients were not fasted for the withdrawal of blood. This measure was taken to prevent discomfort among volunteers. Venous blood samples were collected through aseptic venipuncture on the opposite arm of the arteriovenous fistula by a qualified professional using a vacuum system into heparin or EDTA-containing tubes or tubes without additives according to established standards of clinical and biological safety.

    Change from baseline at 30 and 60 minutes

  • Evaluating heigth

    Height (meters) data were obtained from the patient's files.

    at baseline

  • Evaluating weight

    Weight (kilograms) data were obtained from the patient's files.

    At baseline

  • Evaluating body mass index

    Body mass index (BMI) (Kg/m2) data were obtained from the patient's files.

    At baseline

  • Evaluating medication

    Medication data were obtained from the patient's files.

    At baseline

  • Evaluating adequacy of the dialysis treatment

    Adequacy of the dialysis treatment was captured by extracting the routine Kt/V from the medical record.

    At baseline

Study Arms (1)

Apple Juice

EXPERIMENTAL
Other: Fuji apple juice

Interventions

On two different days, each volunteer consumed 300 mL Fuji apple juice (AJ), immediately after a dialysis section. After a washout period of 3 weeks, the volunteers drank 150 mL Fuji AJ in a similar manner as described above. Before and after 30 and 60 min of AJ consumption, blood samples were withdrawn for biochemical analysis.

Apple Juice

Eligibility Criteria

Age20 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • hemodialysis treatment ≥ 3 months, age ≥ 20 years, and body mass index ≥ 23 kg/m2

You may not qualify if:

  • allergy to apple, presence of cancer or acquired immunodeficiency syndrome, kidney transplant less than 6 months before enrolling in the study, taking antioxidant or nutritional supplements during the 30 days before enrollment, having been hospitalized within 6 weeks before the beginning of the study, or suffering from an acute illness

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (23)

  • Ruskovska T, Jansen EH, Antarorov R. Evaluation of assays for measurement of serum (anti)oxidants in hemodialysis patients. Biomed Res Int. 2014;2014:843157. doi: 10.1155/2014/843157. Epub 2014 May 19.

    PMID: 24982909BACKGROUND
  • Halliwell, B, Gutteridge, JMC. Cellular responses to oxidative stress: adaptation, damage, repair, senescence and death. In: Halliwell, B, Gutteridge, JMC. Free Radical in Biology and Medicine. 4th ed. Oxford, UK: Oxford University Press; 2007, p. 87-267.

    BACKGROUND
  • McDonald CI, Fraser JF, Coombes JS, Fung YL. Oxidative stress during extracorporeal circulation. Eur J Cardiothorac Surg. 2014 Dec;46(6):937-43. doi: 10.1093/ejcts/ezt637. Epub 2014 Jan 30.

    PMID: 24482384BACKGROUND
  • Melidou M, Riganakos K, Galaris D. Protection against nuclear DNA damage offered by flavonoids in cells exposed to hydrogen peroxide: the role of iron chelation. Free Radic Biol Med. 2005 Dec 15;39(12):1591-600. doi: 10.1016/j.freeradbiomed.2005.08.009. Epub 2005 Aug 29.

    PMID: 16298684BACKGROUND
  • Spormann TM, Albert FW, Rath T, Dietrich H, Will F, Stockis JP, Eisenbrand G, Janzowski C. Anthocyanin/polyphenolic-rich fruit juice reduces oxidative cell damage in an intervention study with patients on hemodialysis. Cancer Epidemiol Biomarkers Prev. 2008 Dec;17(12):3372-80. doi: 10.1158/1055-9965.EPI-08-0364.

    PMID: 19064553BACKGROUND
  • Castilla P, Echarri R, Davalos A, Cerrato F, Ortega H, Teruel JL, Lucas MF, Gomez-Coronado D, Ortuno J, Lasuncion MA. Concentrated red grape juice exerts antioxidant, hypolipidemic, and antiinflammatory effects in both hemodialysis patients and healthy subjects. Am J Clin Nutr. 2006 Jul;84(1):252-62. doi: 10.1093/ajcn/84.1.252.

    PMID: 16825703BACKGROUND
  • Shema-Didi L, Sela S, Ore L, Shapiro G, Geron R, Moshe G, Kristal B. One year of pomegranate juice intake decreases oxidative stress, inflammation, and incidence of infections in hemodialysis patients: a randomized placebo-controlled trial. Free Radic Biol Med. 2012 Jul 15;53(2):297-304. doi: 10.1016/j.freeradbiomed.2012.05.013. Epub 2012 May 17.

    PMID: 22609423BACKGROUND
  • Fouque D, Kalantar-Zadeh K, Kopple J, Cano N, Chauveau P, Cuppari L, Franch H, Guarnieri G, Ikizler TA, Kaysen G, Lindholm B, Massy Z, Mitch W, Pineda E, Stenvinkel P, Trevino-Becerra A, Wanner C. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008 Feb;73(4):391-8. doi: 10.1038/sj.ki.5002585. Epub 2007 Dec 19.

    PMID: 18094682BACKGROUND
  • Golding JB, McGlasson WB, Wyllie SG, Leach DN. Fate of apple peel phenolics during cool storage. J Agric Food Chem. 2001 May;49(5):2283-9. doi: 10.1021/jf0015266.

    PMID: 11368590BACKGROUND
  • Dai X, Luo H, Jiang L, Ling L, Xue Y, Yu Z. Efficacy of different sanitizing agents and their combination on microbe population and quality of fresh-cut Chinese chives. J Food Sci. 2012 Jul;77(7):M348-53. doi: 10.1111/j.1750-3841.2012.02770.x. Epub 2012 Jun 18.

    PMID: 22708729BACKGROUND
  • Association of Official Analytical Chemists (AOAC). Official Methods of Analysis. 18th ed. Washington, DC: Association of Official Analytical Chemists; 2005.

    BACKGROUND
  • Singleton, VL, Rossi, JA. Colorimetry of total phenolics with phosphomolybdic phosphotungstic acid reagents. Am J Enol Vitic 1965;16(3):144-58.

    BACKGROUND
  • Arnous, A, Markis, D, Kefalas, P. Correlation of pigment and flavonol content with antioxidant properties in selected aged regional wines from Greece. J Food Composit Ana 2002;15(6):655-65.

    BACKGROUND
  • Brand-Williams, W, Cuvelier, ME, Berset, C. Use of free radical method to evaluate antioxidant activity. LWT Food Sci Technol 1995;28(1):25-30.

    BACKGROUND
  • Giusti, MM, Wrolstad, RE. Anthocyanins: characterization and measurement with UV-visible spectroscopy. In: Wrolstald, RE, ed. Current Protocols in Food Analytical Chemistry. New York, NY: John Wiley and Sons; 2001, p. 1-13.

    BACKGROUND
  • Erel O. A novel automated direct measurement method for total antioxidant capacity using a new generation, more stable ABTS radical cation. Clin Biochem. 2004 Apr;37(4):277-85. doi: 10.1016/j.clinbiochem.2003.11.015.

    PMID: 15003729BACKGROUND
  • Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem. 2005 Dec;38(12):1103-11. doi: 10.1016/j.clinbiochem.2005.08.008. Epub 2005 Oct 7.

    PMID: 16214125BACKGROUND
  • Chung WY, Chung JK, Szeto YT, Tomlinson B, Benzie IF. Plasma ascorbic acid: measurement, stability and clinical utility revisited. Clin Biochem. 2001 Nov;34(8):623-7. doi: 10.1016/s0009-9120(01)00270-3.

    PMID: 11849621BACKGROUND
  • Giustarini D, Dalle-Donne I, Milzani A, Fanti P, Rossi R. Analysis of GSH and GSSG after derivatization with N-ethylmaleimide. Nat Protoc. 2013 Sep;8(9):1660-9. doi: 10.1038/nprot.2013.095. Epub 2013 Aug 1.

    PMID: 23928499BACKGROUND
  • Johansson LH, Borg LA. A spectrophotometric method for determination of catalase activity in small tissue samples. Anal Biochem. 1988 Oct;174(1):331-6. doi: 10.1016/0003-2697(88)90554-4.

    PMID: 3064653BACKGROUND
  • Wendel A. Glutathione peroxidase. Methods Enzymol. 1981;77:325-33. doi: 10.1016/s0076-6879(81)77046-0. No abstract available.

    PMID: 7329310BACKGROUND
  • National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003 Oct;42(4 Suppl 3):S1-201. No abstract available.

    PMID: 14520607BACKGROUND
  • Ceriello A, Colagiuri S. International Diabetes Federation guideline for management of postmeal glucose: a review of recommendations. Diabet Med. 2008 Oct;25(10):1151-6. doi: 10.1111/j.1464-5491.2008.02565.x.

    PMID: 19046192BACKGROUND

MeSH Terms

Conditions

Diabetes Mellitus

Condition Hierarchy (Ancestors)

Glucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System Diseases

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
principal investigator

Study Record Dates

First Submitted

November 10, 2016

First Posted

November 28, 2016

Study Start

August 1, 2015

Primary Completion

October 1, 2015

Study Completion

October 1, 2015

Last Updated

November 28, 2016

Record last verified: 2016-11