CHILDREN receiving chronic haemodialysis are exposed to ongoing oxidative stress and systemic inflammation, factors that significantly increase their long-term risk of cardiovascular disease. Despite growing interest in antioxidant therapies, evidence in paediatric populations remains limited. A new randomised, placebo-controlled trial provides early evidence that melatonin supplementation may offer anti-inflammatory, lipid-lowering, and antioxidant benefits in this vulnerable group.
The prospective, double-blind study enrolled 40 paediatric patients undergoing chronic haemodialysis, who were randomly assigned to receive either 5 mg of melatonin daily or a placebo for 12 weeks. Biomarkers of inflammation, oxidative stress, and lipid metabolism were assessed at baseline and at the end of the study period. Key outcomes included serum nuclear factor kappa B (NF-κB), malondialdehyde (MDA), and lipid profile parameters.
Melatonin Reduces NF-κB–Mediated Inflammation
At the end of the intervention, children receiving melatonin demonstrated a significant reduction in inflammatory activity, reflected by a decrease in the median percent change of serum NF-κB levels compared with baseline. In contrast, no significant changes were observed in the placebo group. These findings suggest that melatonin may modulate inflammatory pathways implicated in the progression of cardiovascular complications in paediatric dialysis patients.
Improvement in Lipid Profile with Melatonin Supplementation
Melatonin supplementation was also associated with significant improvements in lipid profiles. Total cholesterol and low-density lipoprotein (LDL) cholesterol levels decreased significantly over the 12-week period in the melatonin group, while lipid levels remained unchanged in the placebo group. Dyslipidaemia is a common and challenging complication in children with end-stage kidney disease, and these results highlight a potential adjunctive role for melatonin in cardiovascular risk reduction.
Although serum MDA levels, a marker of oxidative stress, did not significantly decrease in the melatonin group, a significant increase in MDA was observed in patients receiving placebo. This suggests that melatonin may exert a protective antioxidant effect by preventing further oxidative damage rather than directly lowering baseline oxidative stress levels.
Future Research on Melatonin in Paediatric Kidney Disease
The authors conclude that melatonin supplementation appears to be safe and may provide clinically relevant anti-inflammatory and metabolic benefits in paediatric haemodialysis patients. While larger and longer-term studies are needed to confirm these findings and assess clinical outcomes, the results support further investigation of melatonin as a low-cost, well-tolerated adjunct therapy in paediatric nephrology.
Reference
Sayed GA et al. Evaluating the antioxidant and anti-inflammatory effect of melatonin in pediatric hemodialysis patients: a randomized, placebo-controlled trial. Sci Rep. 2026;doi: 10.1038/s41598-025-34264-0.
