Therapeutic Effects of Propolis Supplementation on the Inflammatory State, Oxidative Stress, and Uremic Toxins in dialysis Patients: A Systematic Review.

Chronic renal failure (CRF) is a global health issue, particularly affecting the elderly. The end stage of CRF requires dialysis that it often results in complications such as inflammation, oxidative stress, infections, and various kidney issues. Propolis, a natural bee product rich in antioxidants, may help mitigate these risks for dialysis patients. To search for related articles, we utilized the Cochrane Library, EMBASE, ClinicalTrials.gov, Google Scholar, MEDLINE via PubMed, Web of Science, Scopus, and SID databases without any time limitation, up to May 2025. We included all clinical trials, with or without randomization, and congress abstracts that studied the efficacy of Propolis supplementation in patients receiving dialysis. The quality and risk of bias of the included articles were evaluated in accordance with the guidelines outlined in the Cochrane Collaboration Handbook. Six trials (n = 225 patients/48.4 ± 13.0 years) were included, with Propolis dosages of 200-400 mg/day for 2-6 months. Across studies, inflammatory markers decreased by approximately 8%-42%, including significant reductions in TNF-α (-22.6%, p < 0.001), IL-8 (-41.9%, p = 0.009), IL-17 (-20.0%, p = 0.039), and IFN-γ (-8.3%, p = 0.005) after 8 weeks of Brazilian green Propolis supplementation. Additional trials reported significant reductions in TNF-α levels (p = 0.009 and p = 0.020), while CRP and IL-6 generally remained unchanged (p > 0.05). Oxidative stress improved, with oxLDL levels decreasing by approximately 12.9% (946-824 pg/mL, p = 0.020), although MDA showed no significant changes. Topical Propolis suppressed catheter-site infections (0% vs. 6.7%-10% in controls), although this was not statistically significant. Adverse effects were not mentioned in any study. There were small changes in uremic toxins and gut microbiota. Current evidence suggests that Propolis supplementation may improve inflammatory and oxidative stress biomarkers in patients undergoing dialysis and appears to have an acceptable safety profile. However, because substantial methodological heterogeneity precluded a quantitative meta-analysis, these findings should be interpreted with caution. Larger, well-designed randomized controlled trials are required before definitive clinical recommendations can be made.