Abstract
BackgroundChronic kidney disease (CKD) is a public health problem worldwide, and proteinuria is a well-established marker of disease progression in CKD patients. Propolis, a natural resin produced by bees from plant materials, has anti-inflammatory, immunomodulatory, and anti-oxidant properties, as well as having been shown to have an antiproteinuric effect in experimental CKD. The aim of this study was to evaluate the impact of Brazilian green propolis extract on proteinuria reduction and the changes in the estimated glomerular filtration rate (eGFR).MethodsThis was a randomized, double-blind, placebo-controlled study including patients with CKD caused by diabetes or of another etiology, 18–90 years of age, with an eGFR of 25–70 ml/min per 1.73 m2 and proteinuria (urinary protein excretion > 300 mg/day) or micro- or macro-albuminuria (urinary albumin-to-creatinine ratio > 30 mg/g or > 300 mg/g, respectively). We screened 148 patients and selected 32, randomly assigning them to receive 12 months of Brazilian green propolis extract at a dose of 500 mg/day (n = 18) or 12 months of a placebo (n = 14).ResultsAt the end of treatment, proteinuria was significantly lower in the propolis group than in the placebo group—695 mg/24 h (95% CI, 483 to 999) vs. 1403 mg/24 h (95% CI, 1031 to 1909); P = 0.004—independent of variations in eGFR and blood pressure, which did not differ between the groups during follow-up. Urinary monocyte chemoattractant protein-1 was also significantly lower in the propolis group than in the placebo group—58 pg/mg creatinine (95% CI, 36 to 95) vs. 98 pg/mg creatinine (95% CI, 62 to 155); P = 0.038.ConclusionsBrazilian green propolis extract was found to be safe and well tolerated, as well as to reduce proteinuria significantly in patients with diabetic and non-diabetic CKD.Trial Registration.(ClinicalTrials.gov number NCT02766036. Registered: May 9, 2016).
Highlights
Chronic kidney disease (CKD) is a public health problem worldwide, and proteinuria is a wellestablished marker of disease progression in CKD patients
Since the first demonstrations of the antiproteinuric effect of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), there have been no studies evaluating any new class of drugs with the same impact on proteinuria or renal function [9,10,11]
Study population At baseline, the demographic, clinical, and biochemical characteristics were similar between the propolis and placebo groups (Table 1)
Summary
Chronic kidney disease (CKD) is a public health problem worldwide, and proteinuria is a wellestablished marker of disease progression in CKD patients. The aim of this study was to evaluate the impact of Brazilian green propolis extract on proteinuria reduction and the changes in the estimated glomerular filtration rate (eGFR). Progression to more advanced stages of the disease is associated with high rates of morbidity and mortality, mainly due to cardiovascular diseases, and renal. Since the first demonstrations of the antiproteinuric effect of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), there have been no studies evaluating any new class of drugs with the same impact on proteinuria or renal function [9,10,11]. Natural products have recently come to play an important role in the development and discovery of new drugs [16, 17]
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