Maintaining optimal kidney health is a critical global priority, as the kidneys play a vital role in various physiological processes, such as filtering blood, regulating fluid and electrolyte balance, and producing essential hormones.1 Chronic kidney disease (CKD) is a growing concern, and researchers are investigating the potential of dietary components, known as nutraceuticals, to manage and potentially delay the progression of renal injury.
The normal structure and function of the kidneys are crucial for overall health. Genetic, metabolic, and inflammatory diseases can target various components of the nephron, the functional unit of the kidney. In addition to their filtration functions, the kidneys play a crucial role in maintaining blood pressure, calcium homeostasis, and the production of hormones like erythropoietin and active vitamin D.2
Renal disease is an indication that the kidneys’ normal functions have been compromised, leading to the accumulation of water and waste materials in the body.3
Acute insults to the kidney can result in acute renal injury, which may resolve over time or progress to chronic renal disease, a growing health concern globally. Unfortunately, few pharmaceutical agents currently exist that can effectively delay or prevent the progression of renal injury, making the investigation of dietary components for renal health management an active area of research.
Nutraceuticals, or dietary supplements, have been the focus of ongoing studies exploring their potential benefits in managing renal health. These substances may offer promising therapeutic approaches, although more research in the form of prospective, controlled, randomized clinical trials is needed to demonstrate their clinical usefulness.4
Intervention in the conservative phase of chronic kidney disease is likely to be more effective if performed as early as possible in the course of the disease, as early and regular nephrology care has been shown to be beneficial. Primary care clinicians play a vital role in the identification, monitoring, and management of chronic kidney disease, as it often occurs alongside other conditions, requiring a holistic, patient-centered approach.
Vitamin C
Vitamin C, also known as ascorbic acid, is an essential nutrient with a wide range of physiological functions, including its role in maintaining kidney health.
Vitamin C is a potent antioxidant, and its supplementation has been investigated for its potential benefits in chronic kidney disease. Oxidative stress and inflammation are believed to be major factors contributing to the progression of renal injury, and vitamin C’s antioxidant properties may help mitigate these processes.
Studies have suggested that vitamin C supplementation may help slow the decline in glomerular filtration rate, a measure of kidney function, in individuals with chronic kidney disease.5 Additionally, vitamin C may also help reduce the risk of end-stage renal disease in this population.
However, it is important to note that the optimal dosage of vitamin C for kidney health is still being investigated, and excessive intake of vitamin C may potentially have adverse effects, particularly in individuals with impaired renal function.
Other supplements for kidney health
In addition to vitamin C, other dietary supplements have been explored for their potential benefits in kidney health.
Selenium, a trace mineral with antioxidant properties, has been associated with improved kidney function in observational studies.6 Supplementation with selenium has been investigated as a potential intervention for chronic kidney disease, although the results have been mixed.
Coenzyme Q10, an essential cofactor in the mitochondrial electron transport chain, has also been studied for its potential renal benefits. Some studies have suggested that coenzyme Q10 supplementation may help improve kidney function in individuals with chronic kidney disease.7
Moreover, the importance of maintaining adequate levels of other essential minerals, such as zinc and potassium, has been highlighted in the context of kidney health.
In summary, the investigation of dietary supplements for the management of chronic kidney disease is an active area of research.
Astragalus
Astragalus is a herb that has been used in traditional Chinese medicine for centuries. In recent years, astragalus has garnered attention for its potential benefits in the context of kidney health.
Astragalus is believed to possess antioxidant and anti-inflammatory properties, which may be particularly relevant in the context of chronic kidney disease.8 Studies have suggested that astragalus may help slow the progression of renal dysfunction and reduce the risk of end-stage renal disease.
While the evidence on the use of astragalus for kidney health is promising, more high-quality, well-designed clinical trials are needed to establish its efficacy and safety in the management of chronic kidney disease.
Dandelion
Dandelion is a common weed that has been used in traditional medicine for its potential health benefits, including its potential effects on kidney function. Dandelion is believed to possess diuretic properties, which may help increase urine output and potentially improve kidney function. Additionally, dandelion is rich in antioxidants, which may help mitigate the oxidative stress and inflammation associated with chronic kidney disease.9
Some studies have suggested that dandelion extracts may have a protective effect on the kidneys, potentially reducing the risk of kidney stone formation and improving overall renal function.10 However, the evidence on the use of dandelion for kidney health is still limited, and more research is needed to confirm its efficacy and safety.
Glutamine
Glutamine is a non-essential amino acid that has been investigated for its potential benefits in the context of kidney health.
Glutamine has been proposed to play a role in the regulation of acid-base balance, which is important for maintaining normal kidney function.11 Additionally, glutamine has been suggested to have anti-inflammatory and antioxidant properties, which may be relevant in the management of chronic kidney disease.
NAC
N-acetylcysteine (NAC) is a derivative of the amino acid cysteine and has been studied for its potential benefits in the context of kidney disease. NAC is believed to have antioxidant and anti-inflammatory properties, which may be particularly relevant in the management of chronic kidney disease. Results of metanalyses suggested that NAC appears to be safe without obvious adverse events, which can also benefit kidney function, relieve inflammation and reduce cardiovascular events among people with chronic kidney desease.12
Some studies have investigated the use of NAC in individuals with chronic kidney disease, with some suggesting potential benefits in slowing the progression of renal dysfunction and reducing the risk of end-stage renal disease.13
The proposed mechanisms by which NAC may exert its protective effects on the kidneys include:
- Reducing oxidative stress and inflammation
- Improving endothelial function and renal blood flow
- Modulating pathways involved in the development of fibrosis and renal injury.
Resveratrol
Resveratrol is a polyphenol compound found in various plants, including grapes and red wine. Resveratrol has been investigated for its potential benefits in the context of kidney health. Studies have suggested that resveratrol may possess antioxidant, anti-inflammatory, and anti-fibrotic properties, which may be relevant in the management of chronic kidney disease. Available in vitro and in vivo animal and human studies examining the effects of RSV in kidney disease indicate that it can reduce fibrosis, mesangial expansion, oxidative stress, and inflammatory cytokine levels, while improving kidney structure and function (Figure 1).14
Some research has indicated that resveratrol may improve markers of kidney function, such as glomerular filtration rate, and potentially slow the progression of kidney disease.15
Conclusion
Research into the potential role of dietary supplements in managing kidney disease is both active and promising. Maintaining kidney health is crucial and should be prioritized consistently.
References:
1 Fraser, S., & Blakeman, T. (2016, August 1). Chronic kidney disease: identification and management in primary care. Dove Medical Press, Volume 7, 21-32. https://doi.org/10.2147/por.s97310
2 Akilesh, S. (2014, January 1). Normal Kidney Function and Structure. Elsevier BV, 2716-2733. https://doi.org/10.1016/b978-0-12-386456-7.05402-2
3 Pillai, A., & Fulmali, D G. (2023, January 1). A Narrative Review of New Treatment Options for Diabetic Nephropathy. Cureus, Inc.. https://doi.org/10.7759/cureus.33235
4 Locatelli, F., Vecchio, L D., & Pozzoni, P. (2002, November 1). The importance of early detection of chronic kidney disease. Oxford University Press, 17(suppl 11), 2-7. https://doi.org/10.1093/ndt/17.suppl_11.2
5 Wang, C., Zhao, J., Zhou, Q., & Li, J. (2024). Serum vitamin C levels and their correlation with chronic kidney disease in adults: a nationwide study. Renal Failure, 46(1). https://doi.org/10.1080/0886022X.2023.2298079
6 Wang, T., Zhang, L., Liu, Y., Li, J., Chen, G., Zhou, H., Ling, Y., Wan, Z., Dong, C., Qin, L., & Chen, J. (2023, March 17). Combined Exposure to Multiple Metals and Kidney Function in a Midlife and Elderly Population in China: A Prospective Cohort Study. Multidisciplinary Digital Publishing Institute, 11(3), 274-274. https://doi.org/10.3390/toxics11030274
7 Bakhshayeshkaram M, Lankarani KB, Mirhosseini N, et al. The Effects of Coenzyme Q10 Supplementation on Metabolic Profiles of Patients with Chronic Kidney Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Curr Pharm Des. 2018;24(31):3710-3723. doi:10.2174/1381612824666181112112857
8 Yoshino T, Horiba Y, Mimura M, Watanabe K. Oral Astragalus Root Supplementation for Mild to Moderate Chronic Kidney Disease: A Self-Controlled Case-Series. Front Pharmacol. 2022;13:775798. Published 2022 Mar 1. doi:10.3389/fphar.2022.775798
9 Clare BA, Conroy RS, Spelman K. The diuretic effect in human subjects of an extract of Taraxacum officinale folium over a single day. J Altern Complement Med. 2009;15(8):929-934. doi:10.1089/acm.2008.0152
10 Yousefi Ghale-Salimi, M., Eidi, M., Ghaemi, N., & Khavari-Nejad, R. A. (2018). Inhibitory effects of taraxasterol and aqueous extract of Taraxacum officinale on calcium oxalate crystallization: in vitro study. Renal Failure, 40(1), 298–305. https://doi.org/10.1080/0886022X.2018.1455595
