Discussion
loss of renal function, CKD, breast cancer, micro-and macro-vascular complications, diabetes mellitus, proteinuria, hyperglycemia, renal dysfunction, diabetes
BREAST CANCER, OXIDATIVE STRESS, DIABETES MELLITUS, COVID-19 INFECTION, HYPERGLYCEMIA, DIABETES
In the current study, CKD patients with a moderate loss of renal function due to different conditions were studied. The propolis supplementation at a dose of 250 mg daily for three months significantly improved some dimensions of HRQoL in patients with CKD (symptoms/problems, overall health, and general health). To the best of our knowledge, this is the first clinical trial investigating the effect of propolis supplementation on quality of life, PAB, renal function and glycemic parameters, and BP in CKD patients.Oxidative stress is defined as a state of imbalance between pro-oxidants and antioxidants in favor of pro-oxidantsChronic hyperglycemia is the major cause of micro-and macro-vascular complications associated with diabetes mellitus and the leading reason for CKDThis study also showed that propolis had no significant effects on BP as one of the leading causes of CKD. In accordance with our findings, Silveira et al. reported that propolis supplements at a daily dose of 500 mg for one year had no effect on BP in CKD patientsOnly few studies have been carried out using CKD models. Silveira et al. reported that daily consumption of 500 mg propolis extract for one year in patients with CKD significantly reduced proteinuria but not plasma creatinineThe present study showed that propolis supplementation at a dose of 250 mg daily for three months improved some dimensions of HRQoL in patients with CKD (symptoms/problems, overall health, and general health). Davoodi et al. also found that propolis administration (250 mg/day for three months) in patients diagnosed with breast cancer receiving chemotherapy improved the quality of life, particularly with regards to global quality of life as well as emotional functioning and financial difficulties compared to the placebo groupThere were some limitations in this research. The chemical profile of the propolis extract was determined by the manufacturer laboratory in Isfahan, Iran, including general information, and the effective components and their exact values within each capsule were not identified. Additionally, serum levels of propolis bioactive compounds were not measured for assessing the patients’ compliance to propolis supplementation; however, compliance rate was measured by counting the returned capsules by the participants during the pre-arranged appointments. Notably, one of the challenges we faced was that the study was conducted at the peak of the COVID-19 pandemic in IRAN, so some participants may had asymptomatic COVID-19 infection, that affected the results. The relatively low dose of porpolis—due to safety considerations for CKD patients—and the short duration of intervention, which may be the reasons for the lack of significant changes in serum creatinine and proteinuria, are other limitations of this study. All patients had stages 2 and 3 of CKD, so the generalizability of these results in patients with more advanced stages of CKD needs to be confirmed in future clinical trials. However, attempts were made to overcome the impact of limitations by stratified block randomization with a block size of two (based on age and present of diabetes), adjusting the results for confounding factors, and involvement of patients with CKD of different causes.In conclusion, treatment with Iranian poplar type propolis may improve HRQoL in patients with CKD of any causes and moderate renal dysfunction. These results indicated the therapeutic effects of Iranian poplar type propolis in this group of patients, and opened a window for further researches on this compound with larger sample size, longer duration, and higher dosage, considering propolis as an adjuvant therapy in CKD patients.