Effectiveness of Garlic Extract (Allium sativum) to Reduce Level of Malondialdehyde Serum and Improve Quality of Life in Patients with Chronic Hemodialysis: A Randomized Double-Blind Placebo-Controlled Trial

Authors

Amelia Istiqomah, Fakultas Kedokteran, Universitas Sriwijaya, Palembang, Sumatera SelatanFollow
Zulkhair Ali, Divisi Nefrologi dan Hipertensi, Bagian/KSM Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Sriwijaya, Palembang, Sumatera SelatanFollow
Irsan Saleh, Bagian Farmakologi, Fakultas Kedokteran Universitas Sriwijaya, Palembang, Sumatera SelatanFollow

Abstract

Introduction. Study reported that malondialdehyde (MDA) levels as an in vivo marker of oxidative stress were increased in patients undergoing hemodialysis. Antioxidants allicin compounds contained in garlic (Allium sativum) are known to have antioxidant activity by inducing antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT) and inhibiting prooxidant enzymes (nitric oxide synthase, xanthine, NADPH oxidase, and cyclooxygenase). This study aimed to investigate the effectiveness of Allium sativum to reduce level of MDA serum and improve quality of life in patients with chronic hemodialysis. Methods. This study was a crossover randomized double-blind placebo-controlled trial. The subjects were 40 chronic kidney disease (CKD) stage 5 patients with chronic hemodialysis (HD). Subjects were randomly divided into 2 groups, namely the group that received 1,000 mg of garlic extract per day (2 x 500 mg) for 6 weeks and the group that received a placebo, which was then carried out during a washing period for 2 weeks and then the two groups were crossover. Each group measured the levels of serum MDA before and after treatment, also fill in kidney disease quality of life (KDQOL) SF-36 questionnaire. Results. Out of 40 subjects, most of them were male (57.5%) with median of age of 48.6 (range 26-59) years. It was found that serum MDA levels before and after garlic extract administration were 2.423 (SD 0.236) nmol/l and 1.649 (SD 0.26) nmol/l (p<0,001) with a mean change of -0.782 (SD 0.735) nmol/l. Statistical analysis showed a significance difference of MDA serum between the two groups. There was significant improvement in quality of life before and after garlic extract administration from 57.81 (SD 16.95) to 67.62 (SD 13.61) with a mean change of 9.81 (SD 3.34). But there was no significant difference between quality of life and MDA serum. Conclusion. There is effectiveness of garlic extract to decrease serum MDA and improve the quality of life in patients with CKD stage 5 using chronic HD at Mohammad Hoesin Hospital, Palembang.

Bahasa Abstract

Pendahuluan. Studi menunujukkan kadar malondialdehid (MDA) yang merupakan penanda stres oksidatif in vivo meningkat pada pasien yang menjalani hemodialisis (HD). Senyawa alisin yang terkandung di dalam bawang putih (Allium sativum) diketahui memiliki aktivitas antioksidatif dengan menginduksi enzim antioksidan seperti superoxide dismutase (SOD), katalase (CAT) dan menghambat pembentukan enzim prooksidan (nitric oxide synthase, xanthine, NADPH oksidase, dan siklooksigenase). Studi ini dilakukan untuk mengetahui efektivitas ekstrak Allium sativum terhadap penurunan kadar MDA serum dan peningkatan kualitas hidup pada pasien HD kronis. Metode. Penelitian ini merupakan studi crossover randomized double-blind placebo-controlled trial. Subjek penelitian meliputi 40 pasien penyakit ginjal kronis (PGK) stadium 5 yang menjalani hemodialisis kronis di Rumah Sakit Mohammad Hoesin Palembang. Subjek dibagi secara acak menjadi 2 kelompok, yaitu kelompok yang mendapat ekstrak bawang putih 1.000 mg perhari (2 x 500 mg) selama 6 minggu dan kelompok yang mendapatkan plasebo. Kemudian, dilakukan periode wash-out selama 2 minggu dan setelah itu kedua kelompok diberikan perlakuan bergantian. Masing masing kelompok diukur kadar MDA serum sebelum dan setelah perlakuan dan mengisi kuesioner kidney disease quality of life (KDQOL) SF-36. Hasil. Dari 40 subjek penelitian, mayoritas adalah laki-laki yaitu sebanyak 23 pasien (57,5%) dan median usia subjek 48,6 (rentang 26-59) tahun. Didapati kadar MDA serum sebelum dan sesudah pemberian ekstrak bawang putih 2,423 [simpang baku (SB) 0,236] nmol/l menjadi 1,649 (SB 0,26) nmol/l (p<0,001) dan perubahannya memiliki rerata -0,782 (SB 0,735) nmol/l. Didapati perbedaan kadar MDA serum yang bermakna pada uji statistik setelah perlakuan pada kedua kelompok. Terdapat peningkatan kualitas hidup sebelum dan sesudah pemberian ekstrak bawang putih 57,81 (SB 16,95) menjadi 67,62 (SB 13,61), serta perubahannya memiliki rerata 9,81 (SB 3,34). Namun, tidak terdapat korelasi yang bermakna antara kadar MDA serum dengan skor KDQOL. Kesimpulan. Terdapat efektivitas ekstrak bawang putih dalam menurunkan kadar MDA serum dan meningkatkan kualitas hidup pada penderita PGK stadium 5 yang menjalani HD kronis di Rumah Sakit Mohammad Hoesin Palembang. Kata Kunci: Ekstrak bawang putih, hemodialisis kronis, kualitas hidup, malondialdehid serum

Recommended Citation

Istiqomah, Amelia; Ali, Zulkhair; and Saleh, Irsan (2022) "Effectiveness of Garlic Extract (Allium sativum) to Reduce Level of Malondialdehyde Serum and Improve Quality of Life in Patients with Chronic Hemodialysis: A Randomized Double-Blind Placebo-Controlled Trial," Jurnal Penyakit Dalam Indonesia: Vol. 9: Iss. 4, Article 22.
DOI: 10.7454/jpdi.v9i4.1022
Available at: https://scholarhub.ui.ac.id/jpdi/vol9/iss4/22