{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T02:08:55Z","timestamp":1780970935888,"version":"3.54.1"},"reference-count":51,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T00:00:00Z","timestamp":1753488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico (CNPq)","award":["200162\/2020-9"],"award-info":[{"award-number":["200162\/2020-9"]}]},{"name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico (CNPq)","award":["E-26\/202.524\/2019"],"award-info":[{"award-number":["E-26\/202.524\/2019"]}]},{"name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico (CNPq)","award":["E-26\/200.284\/2023"],"award-info":[{"award-number":["E-26\/200.284\/2023"]}]},{"name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro (FAPERJ)","award":["200162\/2020-9"],"award-info":[{"award-number":["200162\/2020-9"]}]},{"name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro (FAPERJ)","award":["E-26\/202.524\/2019"],"award-info":[{"award-number":["E-26\/202.524\/2019"]}]},{"name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro (FAPERJ)","award":["E-26\/200.284\/2023"],"award-info":[{"award-number":["E-26\/200.284\/2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Background: Reducing cardiovascular risk markers is an essential target in chronic kidney disease (CKD). Thus, this study aimed to evaluate the effect of royal jelly plus green propolis supplementation on cardiovascular disease (CVD) risk factors in patients with CKD undergoing hemodialysis (HD). Methods: This randomized, double-blind, placebo-controlled trial involved HD patients allocated to receive either royal jelly plus green propolis EPP-AF\u00ae (100 mg RJ + 500 mg GP) or placebo capsules daily for 2 months. Before and after the intervention period, the biochemical parameters, inflammatory cytokines, and uremic toxins were measured. Results: A total of 38 HD patients completed the 2-month supplementation study, with 19 patients in each group. After 2 months, the treated group showed a significant reduction in plasma levels of IL-6 (0.78 to 0.63 pg\/mL, p = 0.008) and total cholesterol (138.60 to 111.85 mg\/dL, p = 0.03), whereas no changes were observed in the placebo group. Uremic toxins did not change after intervention. Conclusion: Apitherapy with RJ + GP EPP-AF\u00ae extract significantly reduced plasma IL-6 and total cholesterol in HD patients. This supplementation shows promise as a non-pharmacological strategy to reduce cardiovascular risk markers in this population.<\/jats:p>","DOI":"10.3390\/toxins17080369","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T08:51:33Z","timestamp":1753692693000},"page":"369","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Apitherapy with Royal Jelly and Green Propolis EPP-AF\u00ae Improves Cardiovascular Risk Markers in Patients Undergoing Hemodialysis"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6739-8832","authenticated-orcid":false,"given":"Julie Ann","family":"Kemp","sequence":"first","affiliation":[{"name":"Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niter\u00f3i 24033-900, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Mendon\u00e7a","sequence":"additional","affiliation":[{"name":"Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niter\u00f3i 24033-900, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paloma","family":"Chrispim","sequence":"additional","affiliation":[{"name":"Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niter\u00f3i 24033-900, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4957-3630","authenticated-orcid":false,"given":"Marcia","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Graduate Program in Biological Sciences\u2013Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-941, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0737-6127","authenticated-orcid":false,"given":"Isadora","family":"Britto","sequence":"additional","affiliation":[{"name":"Graduate Program in Biological Sciences\u2013Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-941, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2489-1237","authenticated-orcid":false,"given":"Karen S.","family":"Coutinho-Wolino","sequence":"additional","affiliation":[{"name":"Graduate Program in Biological Sciences\u2013Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-941, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8663-3364","authenticated-orcid":false,"given":"Marcelo","family":"Ribeiro-Alves","sequence":"additional","affiliation":[{"name":"HIV\/AIDS Clinical Research Center, Evandro Chagas National Institute of Infectious Diseases (INI\/Fiocruz), Rio de Janeiro 21040-360, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9647-6350","authenticated-orcid":false,"given":"Lia S.","family":"Nakao","sequence":"additional","affiliation":[{"name":"Basic Pathology Department, Federal University of Paran\u00e1 (UFPR), Curitiba 81531-980, PR, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7889-2748","authenticated-orcid":false,"given":"Fernanda","family":"Kussi","sequence":"additional","affiliation":[{"name":"Basic Pathology Department, Federal University of Paran\u00e1 (UFPR), Curitiba 81531-980, PR, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3491-3396","authenticated-orcid":false,"given":"Eduardo B.","family":"Coelho","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Ribeir\u00e3o Preto Medical School, University of S\u00e3o Paulo (USP), S\u00e3o Paulo 14048-900, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5719-1301","authenticated-orcid":false,"given":"Andresa A.","family":"Berretta","sequence":"additional","affiliation":[{"name":"Research, Development & Innovation Department, Apis Flora Indl. 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Ltd, Ribeir\u00e3o Preto 14020-670, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6752-6056","authenticated-orcid":false,"given":"Denise","family":"Mafra","sequence":"additional","affiliation":[{"name":"Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niter\u00f3i 24033-900, RJ, Brazil"},{"name":"Graduate Program in Biological Sciences\u2013Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 21941-941, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludmila","family":"Cardozo","sequence":"additional","affiliation":[{"name":"Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niter\u00f3i 24033-900, RJ, Brazil"},{"name":"Graduate Program in Cardiovascular Sciences, Fluminense Federal University (UFF), Niter\u00f3i 24033-900, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1016\/S0140-6736(18)31694-5","article-title":"Forecasting Life Expectancy, Years of Life Lost, and All-Cause and Cause-Specific Mortality for 250 Causes of Death: Reference and Alternative Scenarios for 2016\u201340 for 195 Countries and Territories","volume":"392","author":"Foreman","year":"2018","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"100624","DOI":"10.1016\/j.xkme.2023.100624","article-title":"All-Cause and Cardiovascular-Related Mortality in CKD Patients With and Without Heart Failure: A Population-Based Cohort Study in Kaiser Permanente Southern California","volume":"5","author":"Yu","year":"2023","journal-title":"Kidney Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1038\/s41581-022-00542-7","article-title":"Epidemiology of Haemodialysis Outcomes","volume":"18","author":"Bello","year":"2022","journal-title":"Nat. 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