Effects of Stevia on Inflammatory Markers, Renal and Hematological Parameters in Patients With Stage I-III Chronic Kidney Disease: A Randomized, Placebo-Controlled Clinical Trial in Bangladesh

Background Global public health policy is concerned about the increasing prevalence of chronic kidney disease (CKD) and its associated comorbidities. Stevioside has been confirmed by food regulatory and safety bodies to be safe and effective for treating diabetes and hypertension. Stevia has also demonstrated a nephroprotective effect in experimental animals. This clinical trial aimed to investigate the kidney-protective effects of stevioside in CKD Stage I-III patients, and to explore its impact on inflammatory markers, kidney function, and hematological parameters as a potential new treatment option. Methods The trial was a prospective, single-blind, placebo-controlled study with 93 participants (83 CKD patients at Stage I-III and 10 healthy controls). The 83 CKD patients were randomly assigned to stevia (250 mg twice daily) or placebo (in addition to standard care), and 10 healthy individuals served as a control group. The study was conducted at the Kidney Foundation Hospital and Research Institute, Dhaka, Bangladesh, from December 2016 to December 2018. Patients were scheduled for follow-up visits every three months for a total of nine months. Data were collected using a systematic, validated, and structured questionnaire. Results At baseline, 44.2% of the CKD patients were in Stage III; by the second follow-up, this proportion had dropped to 38.2%. Stevia treatment significantly reduced systolic blood pressure (p < 0.043), diastolic blood pressure (p < 0.001), microalbuminuria (p < 0.003), postprandial blood sugar (p < 0.001), erythrocyte sedimentation rate (p < 0.023), and high-sensitivity C-reactive protein (p < 0.007) levels at the second follow-up. During the washout period (with no stevia), most of these improved values trended back toward baseline in the stevia group, indicating a loss of the treatment effect upon withdrawal. Conclusion This nine-month clinical investigation found that oral stevia can positively impact biochemical indicators in CKD patients, potentially mitigating the progression of the disease. Therefore, stevia's benefits might offer new interventions to alleviate cardiovascular and metabolic risks in early-stage CKD patients.