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Abdelrahman Hussein, S., Ali Fadlalmola, H., Munir Salama, S., Gaffar Osman, E., & Adam Mariod, A. (2022). Efficacy and Safety of Gum Arabic on Renal Failure Patients: Systematic Review and Meta-analysis. Sudan Journal of Medical Sciences (SJMS), 17(4), 459–475. https://doi.org/10.18502/sjms.v17i4.12547
https://doi.org/10.18502/sjms.v17i4.12547
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- Cited by 1 article
authors
-
Selma Abdelrahman Hussein
Selma Abdelrahman Hussein
Industrial and System Engineering, Engineering College, Princess Nourah Bint Abdulrahman
-
Hammad Ali Fadlalmola
Hammad Ali Fadlalmola
Nursing College, Taibah University, Saudi Arabia
-
Suzy Munir Salama
Suzy Munir Salama
Indigenous Knowledge and Heritage Center, Ghibaish College of Science and Technology, Ghibaish, Sudan
-
Eyas Gaffar Osman
Eyas Gaffar Osman
College of Science and Humanities-Shaqra University, Saudi Arabia
-
Abdalbasit Adam Mariod
Abdalbasit Adam Mariod
College of Sciences and Arts-Alkamil, University of Jeddah, Alkamil, Saudi Arabia
Published Date
- Dec 31, 2022
Efficacy and Safety of Gum Arabic on Renal Failure Patients: Systematic Review and Meta-analysis
Abstract
Background: Chronic Renal Failure (CRF) is a long-term disease caused by progressive kidney dysfunction due to many reasons leading to a significant rise in serum levels of creatinine and urea reaching the advanced stage where the patient goes for frequent hemodialysis. This study aims to discuss the evaluation of the efficacy of gum Arabic (GA) supplementation on the serum level of creatinine, urea, sodium, and potassium in CRF patients.
Methods: Four databases PubMed, Web of Science, Scopus, and the Cochrane Library were searched for clinical trials assessment of gum Arabic intervention in CRF patients. Animal trials and experimental protocols were excluded. Screening of data and data extraction were done by two reviewers independently of each other. Meta-analysis was conducted on the selected studies using RevMan and the resulting description was summarized through the Forest plot tool on the efficacy of GA on 4 variables, creatinine, urea, sodium, and potassium in CRF patients.
Results: From 574 studies searched, only 4 studies were included in this systemic review and meta-analysis. Although one of the studies had proved the objectives of the review but it was removed from the meta-analysis due to the heterogeneity caused by its inclusion.
Conclusion: The few studies included in the current review revealed significant efficacy of GA treatment on the serum level of creatinine, urea, and sodium, but not potassium.
Keywords:
Gum Arabic, Kidney, clinical
References
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[3] Ma, J., Xu, C., Yu, H., Feng, Z., Yu, W., Gu, L., Liu, Z., Chen, L., Jiang, Z., & Hou, J. (2020). Electro-encapsulation of probiotics in gum arabic-pullulan blend nanofibres using electrospinning technology. Food Hydrocolloids. Advance online publication. https://doi.org/10.1016/j.foodhyd.2020.106381
[4] Babiker, M., Abbas, T., & Mohammed, M. (2017). Effect of gum arabic on liver function and antioxidant enzymes of sprague-dawley rats. IOSR Journal of Pharmacy and Biological Sciences, 12(2), 29–33. https://doi.org/10.9790/3008-1202032933
[5] Farman, M. S., Salman, M. I., & Hamad, H. S. (2020). Effect of gum arabic administration on some physiological and biochemical parameters in chronic renal failure patients. Systematic Reviews in Pharmacy, 11(6), 697–701.
[6] Elgazouly, H. M. M., Idris, Y. M. A., & Baraka, B. M. K. (2018). Prebiotication with gum arabic on growth of Bifidobacterium longum BB536 during fermentation of peanut milk. Journal of Agricultural and Veterinary Sciences, 19(2), 12–24.
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[8] Lelon, J., Jumba, I., Keter, J., Chemuku, W., & Oduor, F. (2010). Assessment of physical properties of gum arabic from Acacia Senegal varieties in Baringo District, Kenya. African Journal of Plant Science, 4(4), 95–98.
[9] Ibrahim, N. M., Ali, A. M., Khogali, N., & Bashir, H. S. (2017). Effect of gum arabic as dietary supplement for type II diabetes in Jabir Abu Aliz diabetic center-(Khartoum State). Global Journal of Health Science, 9(7), 168–176. https://doi.org/10.5539/gjhs.v9n7p168
[10] Bussmann, R. W., Paniagua-Zambrana, N. Y., Njoroge, G. N. (2020) Acacia drepanolobium Harmes ex Sjostedt Acacia nilotica (L.) Willd. ex Delile Acacia senegal (L.) Willd. Acacia seyal Delille Acacia tortilis (Forssk.) Hayne Fabaceae. Ethnobotany of the Mountain Regions of Africa. doi.org/https://doi.org/10.1007/978- 3-319-77086-4_4-1
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[12] Al Khodor, S., & Shatat, I. F. (2017). Gut microbiome and kidney disease: A bidirectional relationship. Pediatric Nephrology (Berlin, Germany), 32(6), 921–931. https://doi.org/10.1007/s00467-016-3392-7
[13] Vaziri, N. D., Wong, J., Pahl, M., Piceno, Y. M., Yuan, J., DeSantis, T. Z., Ni, Z., Nguyen, T. H., & Andersen, G. L. (2013). Chronic kidney disease alters intestinal microbial flora. Kidney International, 83(2), 308–315. https://doi.org/10.1038/ki.2012.345
[14] Ali, B. H., Al Za’abi, M., Al Suleimani, Y., Manoj, P., Ali, H., Ribeiro, D. A., & Nemmar, A. (2020). Gum arabic reduces inflammation, oxidative, and nitrosative stress in the gastrointestinal tract of mice with chronic kidney disease. Naunyn-Schmiedeberg’s Archives of Pharmacology, 393, 1427–1436. https://doi.org/10.1007/s00210-020- 01844-y
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[16] Rose, S. D., & Strombom, A. J. (2019). A plant-based diet prevents and treats chronic kidney disease. Urology Nephrology, 6(3), 1–28. https://doi.org/10.19080/JOJUN.2018.06.555687
[17] Elamin, S., Alkhawaja, M. J., Bukhamsin, A. Y., Idris, M. A., Abdelrahman, M. M., Abutaleb, N. K., Housawi, A. A. (2017). Gum arabic reduces C-reactive protein in chronic kidney disease patients without affecting urea or indoxyl sulfate levels. International Journal of Nephrology, 2017, 6. doi.org/https://doi.org/10.1155/2017/9501470.
[18] De Rechter, S., Levtchenko, E., Evenepoel, P., & Mekahli, D. (2016). The case hypercalcemia in a child with chronic kidney disease. Kidney International, 90(1), 233–234. https://doi.org/10.1016/j.kint.2015.12.060
[19] Ali, N. E., Kaddam, L. A., Alkarib, S. Y., Kaballo, B. G., Khalid, S. A., Higawee, A., AbdElhabib, A., AlaaAldeen, A., Phillips, A. O., & Saeed, A. M. (2020). Gum arabic (Acacia Senegal) augmented total antioxidant capacity and reduced C-reactive protein among haemodialysis patients in phase II trial. International Journal of Nephrology, 2020, 7214673. https://doi.org/10.1155/2020/7214673
[20] Al-Mosawi, A. J. (2004). Acacia gum supplementation of a low-protein diet in children with end-stage renal disease. Pediatric Nephrology (Berlin, Germany), 19(10), 1156– 1159. https://doi.org/10.1007/s00467-004-1562-5
[21] Ali, A. A., Ali, K. E., Fadlalla, A. E., & Khalid, K. E. (2008). The effects of gum arabic oral treatment on the metabolic profile of chronic renal failure patients under regular haemodialysis in Central Sudan. Natural Product Research, 22(1), 12–21. https://doi.org/10.1080/14786410500463544
[22] Al Mosawi, A. J. (2009). Six-year dialysis freedom in end-stage renal disease. Clinical and Experimental Nephrology, 13(5), 494–500. https://doi.org/10.1007/s10157-009- 0181-7
[23] Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., Stewart, L. A., & the PRISMA-P Group. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4(1), 1–9. https://doi.org/10.1186/2046-4053-4-1
[24] Higgins, J. P., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., Welch, V., & Flemyng, E. (2019). Cochrane handbook for systematic reviews of interventions. John Wiley & Sons. https://doi.org/10.1002/9781119536604
[25] Suliman, S. M., Beliela, M. H., & Hamza, H. (1995). Dialysis and transplantation in Sudan. Saudi Journal of Kidney Diseases and Transplantation, 6(3), 312–314.
[26] Elnour, K. S., Mahgoub, A., Bahroun, S., & Elazomi, A. (2019). Evaluation of serum α-amylase activity in Sudanese patients with chronic renal failure. Libyan Journal of Medical Research, 13(1), 1–7.
[27] Lameire, N., Jager, K., Van Biesen, W., de Bacquer, D., & Vanholder, R. (2005). Chronic kidney disease: A European perspective. Kidney International. Supplement, 68, S30–S38. https://doi.org/10.1111/j.1523-1755.2005.09907.x
[28] Ondrussek-Sekac, M., Navas-Carrillo, D., & Orenes-Piñero, E. (2020). Intestinal microbiota alterations in chronic kidney disease and the influence of dietary components. Critical Reviews in Food Science and Nutrition. Advance online publication. https://doi.org/10.1080/10408398.2020.1761771
[29] Lau, W. L., Savoj, J., Nakata, M. B., & Vaziri, N. D. (2018). Altered microbiome in chronic kidney disease: Systemic effects of gut-derived uremic toxins. Clinical Science (London, England), 132(5), 509–522. https://doi.org/10.1042/CS20171107
[30] Gibson, G. R., Hutkins, R., Sanders, M. E., Prescott, S. L., Reimer, R. A., Salminen, S. J., Scott, K., Stanton, C., Swanson, K. S., Cani, P. D., Verbeke, K., & Reid, G. (2017). Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nature Reviews. Gastroenterology & Hepatology, 14(8), 491–502. https://doi.org/10.1038/nrgastro.2017.75
[31] Bliss, D. Z., Stein, T. P., Schleifer, C. R., & Settle, R. G. (1996). Supplementation with gum arabic fiber increases fecal nitrogen excretion and lowers serum urea nitrogen concentration in chronic renal failure patients consuming a low-protein diet. The American Journal of Clinical Nutrition, 63(3), 392–398. https://doi.org/10.1093/ajcn/63.3.392
[32] Alla, F., & Sadeek, E. A. (2018). Effect of Arabic gum as prebiotics and lactobacillus casei Shirota (LcS) as probiotic on oxidative stress and renal function in adenine– induced chronic renal failure in rats. European Journal of Nutrition & Food Safety, 8(1), 29–46. https://doi.org/10.9734/EJNFS/2018/36022
[33] Tahir, E. E., Shaddad, S. A., Muddathir, A., & Agabna, N. M. (2016). Nephro-protective effect of Acacia senegal against genatmaycin-induced renal damage in rats. World Journal of Pharmaceutical Research, 5(5), 294–303.
[34] Alkarib, S. Y., Saeed, A. M., Khalid, S. A., Groun, E. A., & Ghalib, M. B. (2016). Gum Arabic role in high blood pressure among patients with stage III chronic kidney disease. Journal of Pharmacological and Clinical Research, 1(4), 1–6. https://doi.org/10.19080/JPCR.2016.01.555569
[35] Jung, J., Foroud, T. M., Eckert, G. J., Flury-Wetherill, L., Edenberg, H. J., Xuei, X., Zaidi, S. A., & Pratt, J. H. (2009). Association of the calcium-sensing receptor gene with blood pressure and urinary calcium in African-Americans. The Journal of Clinical Endocrinology and Metabolism, 94(3), 1042–1048. https://doi.org/10.1210/jc.2008- 1861
[2] Dashtdar, M., & Kardi, K. (2018). Benefits of gum arabic, for a solitary kidney under adverse conditions: A case study. Chinese Medicine and Culture, 1(2), 88–96. https://doi.org/10.4103/CMAC.CMAC_22_18
[3] Ma, J., Xu, C., Yu, H., Feng, Z., Yu, W., Gu, L., Liu, Z., Chen, L., Jiang, Z., & Hou, J. (2020). Electro-encapsulation of probiotics in gum arabic-pullulan blend nanofibres using electrospinning technology. Food Hydrocolloids. Advance online publication. https://doi.org/10.1016/j.foodhyd.2020.106381
[4] Babiker, M., Abbas, T., & Mohammed, M. (2017). Effect of gum arabic on liver function and antioxidant enzymes of sprague-dawley rats. IOSR Journal of Pharmacy and Biological Sciences, 12(2), 29–33. https://doi.org/10.9790/3008-1202032933
[5] Farman, M. S., Salman, M. I., & Hamad, H. S. (2020). Effect of gum arabic administration on some physiological and biochemical parameters in chronic renal failure patients. Systematic Reviews in Pharmacy, 11(6), 697–701.
[6] Elgazouly, H. M. M., Idris, Y. M. A., & Baraka, B. M. K. (2018). Prebiotication with gum arabic on growth of Bifidobacterium longum BB536 during fermentation of peanut milk. Journal of Agricultural and Veterinary Sciences, 19(2), 12–24.
[7] Kishimoto, A., Ushida, K., Phillips, G. O., Ogasawara, T., & Sasaki, Y. (2006). Identification of intestinal bacteria responsible for fermentation of gum arabic in pig model. Current Microbiology, 53(3), 173–177. https://doi.org/10.1007/s00284-005- 0219-3
[8] Lelon, J., Jumba, I., Keter, J., Chemuku, W., & Oduor, F. (2010). Assessment of physical properties of gum arabic from Acacia Senegal varieties in Baringo District, Kenya. African Journal of Plant Science, 4(4), 95–98.
[9] Ibrahim, N. M., Ali, A. M., Khogali, N., & Bashir, H. S. (2017). Effect of gum arabic as dietary supplement for type II diabetes in Jabir Abu Aliz diabetic center-(Khartoum State). Global Journal of Health Science, 9(7), 168–176. https://doi.org/10.5539/gjhs.v9n7p168
[10] Bussmann, R. W., Paniagua-Zambrana, N. Y., Njoroge, G. N. (2020) Acacia drepanolobium Harmes ex Sjostedt Acacia nilotica (L.) Willd. ex Delile Acacia senegal (L.) Willd. Acacia seyal Delille Acacia tortilis (Forssk.) Hayne Fabaceae. Ethnobotany of the Mountain Regions of Africa. doi.org/https://doi.org/10.1007/978- 3-319-77086-4_4-1
[11] Hammad, Z. M., & Mohammed, M. H. (2018). Management practices of gum arabic– producing trees. Gum Arabic: Elsevier.
[12] Al Khodor, S., & Shatat, I. F. (2017). Gut microbiome and kidney disease: A bidirectional relationship. Pediatric Nephrology (Berlin, Germany), 32(6), 921–931. https://doi.org/10.1007/s00467-016-3392-7
[13] Vaziri, N. D., Wong, J., Pahl, M., Piceno, Y. M., Yuan, J., DeSantis, T. Z., Ni, Z., Nguyen, T. H., & Andersen, G. L. (2013). Chronic kidney disease alters intestinal microbial flora. Kidney International, 83(2), 308–315. https://doi.org/10.1038/ki.2012.345
[14] Ali, B. H., Al Za’abi, M., Al Suleimani, Y., Manoj, P., Ali, H., Ribeiro, D. A., & Nemmar, A. (2020). Gum arabic reduces inflammation, oxidative, and nitrosative stress in the gastrointestinal tract of mice with chronic kidney disease. Naunyn-Schmiedeberg’s Archives of Pharmacology, 393, 1427–1436. https://doi.org/10.1007/s00210-020- 01844-y
[15] Mariod, A. A. (2018). Gum arabic: Structure, properties, application and economics. Academic Press.
[16] Rose, S. D., & Strombom, A. J. (2019). A plant-based diet prevents and treats chronic kidney disease. Urology Nephrology, 6(3), 1–28. https://doi.org/10.19080/JOJUN.2018.06.555687
[17] Elamin, S., Alkhawaja, M. J., Bukhamsin, A. Y., Idris, M. A., Abdelrahman, M. M., Abutaleb, N. K., Housawi, A. A. (2017). Gum arabic reduces C-reactive protein in chronic kidney disease patients without affecting urea or indoxyl sulfate levels. International Journal of Nephrology, 2017, 6. doi.org/https://doi.org/10.1155/2017/9501470.
[18] De Rechter, S., Levtchenko, E., Evenepoel, P., & Mekahli, D. (2016). The case hypercalcemia in a child with chronic kidney disease. Kidney International, 90(1), 233–234. https://doi.org/10.1016/j.kint.2015.12.060
[19] Ali, N. E., Kaddam, L. A., Alkarib, S. Y., Kaballo, B. G., Khalid, S. A., Higawee, A., AbdElhabib, A., AlaaAldeen, A., Phillips, A. O., & Saeed, A. M. (2020). Gum arabic (Acacia Senegal) augmented total antioxidant capacity and reduced C-reactive protein among haemodialysis patients in phase II trial. International Journal of Nephrology, 2020, 7214673. https://doi.org/10.1155/2020/7214673
[20] Al-Mosawi, A. J. (2004). Acacia gum supplementation of a low-protein diet in children with end-stage renal disease. Pediatric Nephrology (Berlin, Germany), 19(10), 1156– 1159. https://doi.org/10.1007/s00467-004-1562-5
[21] Ali, A. A., Ali, K. E., Fadlalla, A. E., & Khalid, K. E. (2008). The effects of gum arabic oral treatment on the metabolic profile of chronic renal failure patients under regular haemodialysis in Central Sudan. Natural Product Research, 22(1), 12–21. https://doi.org/10.1080/14786410500463544
[22] Al Mosawi, A. J. (2009). Six-year dialysis freedom in end-stage renal disease. Clinical and Experimental Nephrology, 13(5), 494–500. https://doi.org/10.1007/s10157-009- 0181-7
[23] Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., Stewart, L. A., & the PRISMA-P Group. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4(1), 1–9. https://doi.org/10.1186/2046-4053-4-1
[24] Higgins, J. P., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., Welch, V., & Flemyng, E. (2019). Cochrane handbook for systematic reviews of interventions. John Wiley & Sons. https://doi.org/10.1002/9781119536604
[25] Suliman, S. M., Beliela, M. H., & Hamza, H. (1995). Dialysis and transplantation in Sudan. Saudi Journal of Kidney Diseases and Transplantation, 6(3), 312–314.
[26] Elnour, K. S., Mahgoub, A., Bahroun, S., & Elazomi, A. (2019). Evaluation of serum α-amylase activity in Sudanese patients with chronic renal failure. Libyan Journal of Medical Research, 13(1), 1–7.
[27] Lameire, N., Jager, K., Van Biesen, W., de Bacquer, D., & Vanholder, R. (2005). Chronic kidney disease: A European perspective. Kidney International. Supplement, 68, S30–S38. https://doi.org/10.1111/j.1523-1755.2005.09907.x
[28] Ondrussek-Sekac, M., Navas-Carrillo, D., & Orenes-Piñero, E. (2020). Intestinal microbiota alterations in chronic kidney disease and the influence of dietary components. Critical Reviews in Food Science and Nutrition. Advance online publication. https://doi.org/10.1080/10408398.2020.1761771
[29] Lau, W. L., Savoj, J., Nakata, M. B., & Vaziri, N. D. (2018). Altered microbiome in chronic kidney disease: Systemic effects of gut-derived uremic toxins. Clinical Science (London, England), 132(5), 509–522. https://doi.org/10.1042/CS20171107
[30] Gibson, G. R., Hutkins, R., Sanders, M. E., Prescott, S. L., Reimer, R. A., Salminen, S. J., Scott, K., Stanton, C., Swanson, K. S., Cani, P. D., Verbeke, K., & Reid, G. (2017). Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nature Reviews. Gastroenterology & Hepatology, 14(8), 491–502. https://doi.org/10.1038/nrgastro.2017.75
[31] Bliss, D. Z., Stein, T. P., Schleifer, C. R., & Settle, R. G. (1996). Supplementation with gum arabic fiber increases fecal nitrogen excretion and lowers serum urea nitrogen concentration in chronic renal failure patients consuming a low-protein diet. The American Journal of Clinical Nutrition, 63(3), 392–398. https://doi.org/10.1093/ajcn/63.3.392
[32] Alla, F., & Sadeek, E. A. (2018). Effect of Arabic gum as prebiotics and lactobacillus casei Shirota (LcS) as probiotic on oxidative stress and renal function in adenine– induced chronic renal failure in rats. European Journal of Nutrition & Food Safety, 8(1), 29–46. https://doi.org/10.9734/EJNFS/2018/36022
[33] Tahir, E. E., Shaddad, S. A., Muddathir, A., & Agabna, N. M. (2016). Nephro-protective effect of Acacia senegal against genatmaycin-induced renal damage in rats. World Journal of Pharmaceutical Research, 5(5), 294–303.
[34] Alkarib, S. Y., Saeed, A. M., Khalid, S. A., Groun, E. A., & Ghalib, M. B. (2016). Gum Arabic role in high blood pressure among patients with stage III chronic kidney disease. Journal of Pharmacological and Clinical Research, 1(4), 1–6. https://doi.org/10.19080/JPCR.2016.01.555569
[35] Jung, J., Foroud, T. M., Eckert, G. J., Flury-Wetherill, L., Edenberg, H. J., Xuei, X., Zaidi, S. A., & Pratt, J. H. (2009). Association of the calcium-sensing receptor gene with blood pressure and urinary calcium in African-Americans. The Journal of Clinical Endocrinology and Metabolism, 94(3), 1042–1048. https://doi.org/10.1210/jc.2008- 1861