Nutrients, Nutraceuticals, and Xenobiotics Affecting Renal Health

Abstract

Chronic kidney disease (CKD) affects 8–16% of the population worldwide. In developed countries, the most important risk factors for CKD are diabetes, hypertension, and obesity, calling into question the importance of educating and acting on lifestyles and nutrition. A balanced diet and supplementation can indeed support the maintenance of a general health status, including preservation of renal function, and can help to manage and curb the main risk factors for renal damage. While the concept of protein and salt restriction in nephrology is historically acknowledged, the role of some nutrients in renal health and the importance of nutrition as a preventative measure for renal care are less known. In this narrative review, we provide an overview of the demonstrated and potential actions of some selected nutrients, nutraceuticals, and xenobiotics on renal health and function. The direct and indirect effects of fiber, protein, fatty acids, curcumin, steviol glycosides, green tea, coffee, nitrates, nitrites, and alcohol on kidney health are reviewed here. In view of functional and personalized nutrition, understanding the renal and systemic effects of dietary components is essential since many chronic conditions, including CKD, are related to systemic dysfunctions such as chronic low-grade inflammation.

Association of Blood Pressure Trajectories in Early Life with Subclinical Renal Damage in Middle Age

“…9,35 Cigarette smoking and alcohol consumption are not only risk factors for hypertension but also, independently associated with CKD. 36,37 In our study, the high stable (low increasing) and moderate increasing groups were associated with higher rates of smoking and drinking in SBP and DBP trajectories. Furthermore, higher-level trajectory groups had markedly abnormal metabolic risk factors, because the moderate stable, high stable (low increasing), and moderate increasing groups were related to higher incidence of diabetes; hyperlipidemia; higher BMI, GLU, TC, TG, and LDL-C; and lower HDL-C. BMI in early life played an important role in the development of hypertension 38 and CKD.…”

Dietary Fiber and Gut Microbiota in Renal Diets

“…Whether dietary fiber per se or the other nutrients that are present in the foods that are high in fiber decrease systemic inflammation is still an open question. Fruits and vegetables contain vitamins and antioxidants, making these foods necessary for a healthy diet, and natural sources are to be preferred [79]. Bioavailability of phosphorus in fruits, vegetables, and whole grains is lower when compared to processed food [80].…”

Dietary Fiber and Gut Microbiota in Renal Diets

“…The question if dietary fiber per se or the other nutrients that are present in the foods that are high in fiber decrease systemic inflammation is still open. Fruits and vegetables intake vitamins and antioxidant, that make these foods necessary for a healthy diet, and natural sources are to be preferred [51]. Bioavailability of potassium and phosphorus in fruits, vegetables and whole grains is lower when compared to processed food [52].To reach sufficient amount of dietary fiber and to ensure a low potassium content in diet for patients with advanced CKD, vegetable should be cooked by boiling in water before ingestion and the fruit should be properly selected.…”