Journal Article

Effects of Brazilian green propolis on proteinuria and renal function in patients with chronic kidney disease: a randomized, double-blind, placebo-controlled trial

Teles, Flávio, Silveira, Marcelo Augusto Duarte, Berretta, Andressa A., Sanches, Talita R., Rodrigues, Camila Eleutério, Andrade, Lúcia, Seguro, Antonio Carlos

2019

Overview

Background Chronic 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). Methods This 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 m 2 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). Results At 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. Conclusions Brazilian 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).

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Age / Anti-Inflammatory Agents - administration & dosage / Anti-Inflammatory Agents - adverse effects / Antioxidants - administration & dosage / Antioxidants - adverse effects / Blood pressure / Care and treatment / Chronic kidney failure / Clinical Research / Creatinine / Development and progression / Diabetes / Diabetes mellitus / Disease Progression / Double-blind studies / Drugs / Enzymes / Epidermal growth factor receptors / Etiology / Excretion / Female / Forecasts and trends / Glomerular filtration rate / Glomerular Filtration Rate - drug effects / Health aspects / Humans / Hypertension / Immunomodulation / Inflammation / Internal Medicine / Kidney diseases / Male / Medicine / Medicine & Public Health / Middle Aged / Monocyte chemoattractant protein / Monocyte chemoattractant protein 1 / Monocytes / Mortality / Nephrology / Plant Exudates - administration & dosage / Plant Exudates - adverse effects / Propolis / Propolis - administration & dosage / Propolis - adverse effects / Proteins / Proteinuria / Proteinuria - diagnosis / Proteinuria - drug therapy / Proteinuria - etiology / Public health / Renal Elimination - drug effects / Renal function / Renal Insufficiency, Chronic - diagnosis / Renal Insufficiency, Chronic - drug therapy / Renal Insufficiency, Chronic - urine / Research Article / Transplants & implants / Treatment Outcome