Whey Protein, Vitamins C and E Decrease Interleukin-10 in Chronic Hemodialysis Patients: A Pioneer, Randomized, Double-Blind Pilot Trial.

2024-01
Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 34(1)
- Angela Teodósio da Silva
- Roberta Pieri Machado
- Mayara Lopes Martins
- Luís Eduardo Gomes Dorneles
- Eduardo Monguilhott Dalmarco
- Edson Luiz da Silva
- Patrícia de Fragas Hinnig
- Elisabeth Wazlawik

PubMed: 37598813
DOI: 10.1053/j.jrn.2023.08.007

Study Design

Type: Randomized Controlled Trial (RCT)
Population: hemodialysis (HD) patients
Methods: randomized and double-blinded study; supplementation group received 20 g of whey protein, 250 mg of vitamin C, and 600 IU of vitamin E; placebo group received 20 g of rice flour, and microcrystalline cellulose capsules; interventions given after HD, 3 times a week, for 8 weeks
Blinding: Double-blind
Duration: 8 weeks
Funding: Unclear

Objective

To evaluate the effects of supplementation with whey protein combined with vitamins C and E on inflammatory markers in hemodialysis (HD) patients.

Design and methods

This was a pioneer, randomized and double-blinded study. Patients were randomized into two groups and stratified by HD frequency. The supplementation group received 20 g of whey protein, 250 mg of vitamin C, and 600 IU of vitamin E; the placebo group, 20 g of rice flour, and microcrystalline cellulose capsules. The interventions were given after HD, 3 times a week, for 8 weeks. The inflammatory markers were assessed: interleukin (IL) IL-12p70, IL-10, IL-6, IL-8, and tumor necrosis factor alpha. For statistical analysis, the χ2 test, Student's t-test, Mann-Whitney test, analysis of variance for repeated two-way measurements, paired t test, and Wilcoxon test were performed. P < .05 was considered statistically significant.

Results

Twenty-three patients completed the study. No significant differences were found in inflammatory markers when comparing the groups postintervention. In the intragroup was a decrease in IL-10 in the supplementation group after 8 weeks (P = .0382). IL-6 tended to decrease by 810.95% in the supplementation group and increased by 732.8% (nonsignificant) in the placebo group.

Conclusion

Whey protein combined with vitamins C and E significantly reduced IL-10 in the supplementation group and could be beneficial to reduce IL-6 in HD patients. Future studies are suggested with a larger sample size, different supplementation doses, and longer interventions.

Research Insights

Vitamin C→Increased Interleukin-10 Levels
In the intragroup was a decrease in IL-10 in the supplementation group after 8 weeks (P = .0382).
Effect
Beneficial
Effect size
Small
Dose
600 IU
Vitamin C→Reduced Interleukin-12p70 Level
No significant differences were found in inflammatory markers when comparing the groups postintervention.
Effect
Neutral
Effect size
Small
Dose
600 IU
Vitamin C→Reduced Interleukin-1β Levels
No significant differences were found in inflammatory markers when comparing the groups postintervention.
Effect
Neutral
Effect size
Small
Dose
600 IU
Vitamin C→Reduced Interleukin-6 Levels
IL-6 tended to decrease by 810.95% in the supplementation group and increased by 732.8% (nonsignificant) in the placebo group.
Effect
Neutral
Effect size
Small
Dose
600 IU
Vitamin C→Reduced Tumor Necrosis Factor Alpha
No significant differences were found in inflammatory markers when comparing the groups postintervention.
Effect
Neutral
Effect size
Small
Dose
600 IU
Vitamin E→Increased Interleukin-10 Levels
In the intragroup was a decrease in IL-10 in the supplementation group after 8 weeks (P = .0382).
Effect
Beneficial
Effect size
Small
Dose
600 IU
Vitamin E→Reduced Interleukin-12p70 Level
No significant differences were found in inflammatory markers when comparing the groups postintervention.
Effect
Neutral
Effect size
Small
Dose
600 IU
Vitamin E→Reduced Interleukin-1β Levels
No significant differences were found in inflammatory markers when comparing the groups postintervention.
Effect
Neutral
Effect size
Small
Dose
600 IU
Vitamin E→Reduced Interleukin-6 Levels
IL-6 tended to decrease by 810.95% in the supplementation group and increased by 732.8% (nonsignificant) in the placebo group.
Effect
Neutral
Effect size
Small
Dose
600 IU
Vitamin E→Reduced Tumor Necrosis Factor Alpha
No significant differences were found in inflammatory markers when comparing the groups postintervention.
Effect
Neutral
Effect size
Small
Dose
600 IU
Whey Protein→Increased Interleukin-10 Levels
In the intragroup was a decrease in IL-10 in the supplementation group after 8 weeks (P = .0382).
Effect
Beneficial
Effect size
Small
Dose
600 IU
Whey Protein→Reduced Interleukin-12p70 Level
No significant differences were found in inflammatory markers when comparing the groups postintervention.
Effect
Neutral
Effect size
Small
Dose
600 IU
Whey Protein→Reduced Interleukin-1β Levels
No significant differences were found in inflammatory markers when comparing the groups postintervention.
Effect
Neutral
Effect size
Small
Dose
600 IU
Whey Protein→Reduced Interleukin-6 Levels
IL-6 tended to decrease by 810.95% in the supplementation group and increased by 732.8% (nonsignificant) in the placebo group.
Effect
Neutral
Effect size
Small
Dose
600 IU
Whey Protein→Reduced Tumor Necrosis Factor Alpha
No significant differences were found in inflammatory markers when comparing the groups postintervention.
Effect
Neutral
Effect size
Small
Dose
600 IU