Discussion
gallstones, kidney disease, acute gastrointestinal diseases, diabetic, hypoglycemic, diabetic ESRD, impaired renal function, thyroid abnormalities
HYPERGLYCEMIA, GALLSTONES, KIDNEY DISEASE, HYPOGLYCEMIA, CHRONIC RENAL DISEASE, BLOOD, OXIDATIVE STRESS, IMPAIRED RENAL FUNCTION
To the best of our knowledge, this is the first clinical trial aimed to investigate the effects of ginger supplementation on diabetic ESRD patients undergoing hemodialysis. According to current findings, short-term ginger supplementation for eight weeks in this group of patientsmay improve glycemic control. Besides, it mar have beneficial effects on some renal function parameters. Furthermore, the results showed no significant changes in energy, macronutrients, and micronutrient intake between the two groups at the end of the study compared to the beginning, indicating the diet was not a notable confounder in this study.Blood glucose control in diabetic patients, particularly those on hemodialysis, may be difficult under the shadow of of hypoglycemia. Moreover, these patients' treatment choices are limited due to impaired renal function and the buildup of medication metabolites in the body [The phenols, polyphenols, and flavonoids in ginger are thought to have hypoglycemic effects [In this study, ginger reduced urea levels consistent with prior animal studies [The renoprotective properties in lowering the serum levels of urea may be attributed to polyphenols and flavonoids in ginger [In a live organism, there are several antioxidant and oxidant factors, and a disturbance of the pro-oxidant/antioxidant equilibrium may result in tissue harm. The pro-oxidant antioxidant balance showed substantial promise for mortality prediction in individuals with chronic renal disease, and oxidative stress in diabetic patients were much higher than in healthy individuals [Hyperglycemia increases the production of Reactive oxygen species (ROS), and ginger can reduce ROS levels by lowering serum blood glucose concentrations [The results of the present study indicated that diabetic ESRD patients undergoing hemodialysis who were 18 years of age or older and with no defined history of acute gastrointestinal diseases, thyroid abnormalities, gallstones, or ginger products sensitivity may benefit from ginger supplementation. This study was the first one that evaluated the PAB in kidney disease patients. Moreover, a high percentage of patients' adherence to the study protocol can be considered as another study's strength, indicating negligible side effects of ginger in this group of patients. We did not assess glycosylated hemoglobin, components of the body's antioxidant system such as antioxidant enzymes of SOD, GPx, catalase, serum levels of MDA, and some indicators of the body's oxidant status in urine due to financial constraints. Moreover, it seems that the study's short supplementation duration of eight weeks and the small number of patients included in the study were another drawbacks and the causes of certain non-statistically significant alterations at the conclusion.