Intermittent Fasting—A Healthy Dietary Pattern for Diabetic Nephropathy

Abstract

Diabetic nephropathy (DN), a metabolic disease, is characterized by severe systemic metabolic disorders. A unique dietary pattern, such as intermittent fasting (IF) has shown promising protective effects on various metabolic diseases, such as diabetes and cardiovascular and nervous system diseases. However, its role in regulating kidney disease, especially in DN, is still being investigated. Here, we summarize the current research progress, highlighting the relationship between IF and the risk factors for the progression of DN, and discuss the potential mechanisms by which IF improves renal injury in DN. Finally, we propose IF as a potential strategy to prevent and delay DN progression. Abbreviation: DN: Diabetic nephropathy; IF: Intermittent fasting; CPT1A: Carnitine palmitoyltransferase 1A; L-FABP: Liver-type fatty acid-binding protein; STZ: Streptozotocin; LDL: Low-density lipoproteins; HIIT: High-intensity interval training; CKD: Chronic kidney disease; ACEI: Angiotensin-converting enzyme inhibitors; ARB: Angiotensin receptor blockers; MDA: Malondialdehyde; mtDNA: Mitochondrial DNA; UCP3: Uncoupling protein-3; MAM: Mitochondria-associated endoplasmic reticulum membrane; PBMCs: Peripheral blood mononuclear cells; ERK1/2: Extracellular signal-regulated kinase 1/2; DRP1: Dynamin-related protein 1; β-HB: β-Hydroxybutyrate; AcAc: Acetoacetate; GEO: Gene Expression Omnibus; NCBI: National Center for Biotechnology Information; mTORC1: Mechanistic target of rapamycin complex 1; HMGCS2: 3-Hydroxy-3-methylglutaryl-CoA synthase 2; GSK3β: Glycogen synthase kinase 3β; AKI: Acute kidney injury; CMA: Chaperone-mediated autophagy; FGF21: Fibroblast growth factor 21.

Chronic Kidney Disease in Diabetes: Biomarkers for Early Detection and Management

“…This study also found that urinary L-FABP level in patients with normal albuminuria is higher than that in patients with microalbuminuria regardless of the type of diabetes [40]. Yang [41] et al found that L-FABP expression was significantly increased after intermittent fasting in diabetic nephropathy patients diagnosed by kidney biopsy. In a cross-section study of 106 patients with type 2 diabetes and 30 patients without diabetes, latex-enhanced immunoturbidimetry was used to measure L-FABP and found a significant negative correlation between urinary L-FABP levels and eGFR (r=-0.606, p<0.001).…”

Intermittent Fasting as New Approaches as Anti Aging for Preventing Age-associated Diseases

“…This shift to utilizing fat for energy can lead to more sustained and steady energy levels throughout the day, as opposed to the energy spikes and crashes often associated with frequent meals and carbohydrate-heavy diets. Individuals who practice intermittent fasting often report feeling more alert, focused, and energetic during fasting periods (Yang et al, 2022).…”

Association of NAFLD/NASH, and MAFLD/MASLD with chronic kidney disease: an updated narrative review

“…Although substantial lifestyle changes have been advocated to treat CKD, diet remains relatively underused in the clinics [132,136] . Mechanistically, dietary manipulations might improve renal health via improved function and composition of gut microbiota and therefore changes in the spectrum of microbiota-derived metabolites that may be either nephroprotective (e.g., short-chain fatty acids) or detrimental to renal health (e.g., gut-derived uremic toxins) [136] . Intermittent fasting, a promising approach to delay the progression of CKD, remains under active investigation, particularly in the DN arena [137] .…”