From the Guidelines
To protect renal function with natural supplements, it is essential to consider the latest evidence, which suggests that while several supplements may be beneficial, their use should be approached with caution and under medical supervision, as the current evidence base is not strong enough to support routine use of most supplements in patients with kidney disease, as noted in the most recent guideline 1. When considering natural supplements to protect renal function, several options may be beneficial, though they should complement rather than replace medical treatment.
- Omega-3 fatty acids can reduce inflammation and may slow kidney disease progression, but there is not enough evidence to support their routine use in hospitalized patients with AKI, AKI on CKD, or CKD with kidney failure, as stated in the ESPEN guideline 1.
- Vitamin D helps regulate calcium and phosphorus levels, which is important for kidney health, and patients with CKD or those who are dialysis-dependent are much more likely to have low levels of 25(OH)D, as discussed in the K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease 1.
- CoQ10 acts as an antioxidant that may protect kidney cells from oxidative damage.
- Alpha-lipoic acid has shown promise in reducing oxidative stress in the kidneys.
- Resveratrol supplements may help protect against kidney damage through their antioxidant properties.
- Curcumin from turmeric has anti-inflammatory effects that may benefit kidney health.
- B vitamins, particularly B6, B12, and folate, help manage homocysteine levels which can affect kidney function, and supplementation may be beneficial in dialysis patients, as suggested by the K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients 1. Before starting any supplement regimen, it is crucial to consult with a healthcare provider, especially if you have existing kidney disease, as some supplements may interact with medications or be contraindicated in certain kidney conditions. The most recent guidelines, such as the KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease 1 and the KDOQI US commentary on the KDIGO 2024 clinical practice guideline for the evaluation and management of CKD 1, emphasize the importance of a very low–protein diet supplemented with essential amino acids or ketoacid analogs for adults with CKD at risk of kidney failure, but do not provide strong evidence for the use of natural supplements in protecting renal function.
From the Research
Natural Supplements for Renal Function Protection
Some natural supplements may help protect renal function, including:
- Omega-3 fatty acids, specifically docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which have been shown to protect against diabetic nephropathy by inhibiting inflammation 2
- Certain herbs, such as Cordyceps sinensis, Sairei-to, Rheum spp., Salvia miltiorrhiza, and its component, magnesium lithospermate B, which have been reported to have potential renal benefits 3
Herbs and Dietary Supplements to Avoid
However, some herbs and dietary supplements may be harmful to renal function, including:
- Chinese yew (Taxus celbica) extract, impila (Callilepis laureola), morning cypress (Cupressus funebris Endl), St. John's wort (Hypericum perforatum), thundergod vine (Tripterygium wilfordii hook F), tribulus (Tribulus terrestris), and wormwood (Artemisia herba-alba) 4
- Dietary supplements such as bile (sheep), chlorella, chromium (Cr), CKLS, creatine, gallbladder (fish), glucosamine, hydrazine, N.O.-Xplode, Spanish fly, and excess intakes of vitamins A, C, and D 4
Prevalence of Dietary Supplement Use in CKD Patients
The use of dietary supplements among patients with chronic kidney disease (CKD) is similar to that of patients without CKD, with the exception of those on dialysis, who have a higher rate of supplement use 5
- The most commonly used dietary supplements among CKD patients are vitamins, minerals, and herbs, with major indications for use including musculoskeletal issues, general health improvement, and prevention of urinary tract infections 5