Effects of melatonin on advanced glycation end products, inflammation, and oxidative stress in peritoneal dialysis patients: a randomized controlled trial

Abstract

Advanced glycation end products, systemic and vascular inflammation, and oxidative stress are risk factors for cardiovascular disease in peritoneal dialysis (PD) patients. No studies have examined the effects of melatonin on these risk factors in PD patients. This study was a randomized clinical trial. Forty-four PD patients were randomly assigned to either the melatonin or the placebo group. Participants in the melatonin group received 5 mg melatonin for 10 weeks, while the placebo group received a corresponding placebo. In this study, serum pentosidine, carboxymethyl lysine (CML), high-sensitivity C-reactive protein (hs-CRP), soluble intercellular adhesion molecule type 1 (sICAM-1), malondialdehyde (MDA), and glucose were measured. Serum MDA showed a significant reduction in the melatonin group (P = 0.001), and the reduction was significant compared to the placebo group (P = 0.03). Serum hs-CRP decreased in the melatonin group, and this reduction was significant compared to the placebo group (P = 0.04). Significant reductions were observed in serum sICAM-1 (P = 0.02) and pentosidine (P = 0.03) in the melatonin group. Serum CML and glucose did not show significant changes within each group. This study indicates that nightly administration of 5 mg melatonin reduces MDA, hs-CRP, sICAM-1 and pentosidine, which are cardiovascular risk factors in PD patients. ClinicalTrials.gov: NCT06096558 (23/10/2023).