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Background and Objectives: Cardiovascular diseases are the most important cause of mortality in patients with chronic renal failure, including peritoneal dialysis patients. Oxidative stress and increased plasma concentrations of homocysteine and coagulation factors are the major risk factors for cardiovascular diseases in these patients. Some studies have shown beneficial effects of soy consumption on oxidative stress and hyperhomocysteinemia however, no study has been done in this field in peritoneal dialysis patients so far. The present study was designed to investigate the effects of soy consumption on oxidative stress, blood coagulation activities, and blood homocysteine and phosphorus levels in peritoneal dialysis patients. Materials and Methods: This study was a randomized clinical trial in which 40 peritoneal dialysis patients (20 males and 20 females) were randomly assigned to either the soy or the control group. The patients in the soy group received 28 g/d textured soy flour (containing 14 g soy protein) for 12 weeks, while the patients in the control group received their usual diet without any soy. At the baseline and after 8 weeks 10 ml blood were collected from each patient after a 12 to 14-hour fast and then blood ox-LDL, homocysteine, phosphorus and fibrinogen concentrations and the activities of coagulation factors VII, IX and X were measured. Results: The initial plasma content of coagulation factor IX activity decreased significantly by17% in the soy group at the end of the 8th week (P<0.01), and the magnitude of reduction was significantly different as compared to the control value (P<0.05). The content of coagulation factor IX activity did not change significantly in the control group. The data also showed that there were no significant differences between the mean changes in blood ox-LDL, homocysteine, phosphorus and fibrinogen concentrations and the activities of coagulation factors VII and X of the two groups. Conclusion: The results of the present study indicate that soy consumption reduces plasma coagulation factor IX activity significantly in peritoneal dialysis patients. Therefore, it may be effective in preventing thrombosis and cardiovascular diseases in these patients.

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Background and objectives: Hypercoagulability is an important risk factor for thrombosis and its complications such as ischemic heart disease, stroke and arteriovenous fistula failure in hemodialysis patients. The present study was designed to investigate the effects of L-carnitine supplement on plasma coagulation and anticoagulation factors in hemodialysis patients. Materials and methods: The study was a double-blind randomized clinical trial. Fourty-two hemodialysis patients (25 females and 17 males) were randomly assigned to either a carnitine or a placebo group. The patients in the carnitine group received orally a vial containing 1000 mg L-carnitine daily for 12 weeks, while the placebo group received a corresponding placebo vial. At baseline and at the end of week 12 of the study, 8.5 ml blood was collected from each patient after a 12- to 14-hour fast before dialysis and plasma fibrinogen concentration, activity of plasma protein C, coagulation factors V, VII , IX, and serum concentrations of tPA, PAI-1, free carnitine and CRP were measured. Results: In the carnitine group the mean serum free carnitine concentration increased significantly 150%, while the plasma fibrinogen and the serum CRP decreased 98 mg/dl and 41%, respectively, at the end of week 12, as compared to the baseline value (P<0.001). The reductions were significant as compared to the placebo group (P<0.05). No significant differences were observed between the two groups with regard to mean changes in the activity of plasma protein C, coagulation factors V, VII, IX, and serum PAI-1-to-tPA ratio. Conclusion: The results of the present study indicate that L-carnitine supplement can reduce serum CRP, a systemic inflammatory indicator, and plasma fibrinogen, an inflammation-related coagulation factor, in hemodialysis patients, while it has no effect on coagulation and anticoagulation factors not related to inflammation.