From the Guidelines
Cinnamon bark supplements should be used with caution in chronic kidney disease (CKD) patients, with recommended dosing of no more than 1 gram daily under healthcare supervision, due to the potential risk of acute nephrotoxicity at doses > 1 g/d 1.
Key Considerations
- The use of cinnamon bark supplements in CKD patients requires careful consideration of the potential benefits and risks, including the impact on blood glucose levels, blood pressure, and kidney function 1.
- Patients with CKD should choose Ceylon cinnamon (Cinnamomum verum) rather than Cassia cinnamon, as Ceylon contains lower levels of coumarin, a compound that can potentially stress the kidneys.
- Cinnamon contains compounds that may interact with medications commonly used in CKD, such as certain diabetes medications or blood thinners, and the kidneys' reduced filtering capacity in CKD means that certain compounds in cinnamon may accumulate in the body 1.
Dosing Recommendations
- For CKD patients, a dose of 0.5-1 gram daily may be appropriate, with close monitoring of kidney function and adjustment of the dose as needed 1.
- Patients should start with the lowest effective dose and discontinue use if experiencing any adverse effects such as changes in urine output, increased blood pressure, or worsening kidney function markers.
Monitoring and Precautions
- CKD patients should consult their nephrologist before starting any cinnamon supplementation and have kidney function monitored regularly 1.
- Patients should be aware of the potential risks of acute nephrotoxicity and other adverse effects, and seek medical attention if they experience any symptoms or changes in their condition.
From the Research
Cinnamon Bark and CKD Dosing
- The effectiveness of cinnamon as a therapeutic intervention for chronic kidney disease (CKD) remains unproven, but its bioactive compounds may mitigate oxidative stress, inflammation, hyperglycemia, gut dysbiosis, and dyslipidemia, which are common complications in patients with CKD 2.
- Trans-cinnamic acid, a key active monomer found in cinnamon bark, has been shown to alleviate high-fat diet-induced renal injury via the JNK/ERK/P38 MAPK pathway 3.
- Cinnamon has been found to have multiple health benefits, including hypoglycaemic activity, anti-microbial, anti-fungal, antiviral, antioxidant, anti-tumour, blood pressure-lowering, cholesterol and lipid-lowering, and gastro-protective properties 4.
- Cassia cinnamon has been shown to demonstrate a therapeutic effect in reducing fasting blood glucose by 10.3%-29% in patients with type 2 diabetes, but its effect on CKD is still unknown 5.
- There is no direct evidence on the dosing of cinnamon bark for CKD, but the studies suggest that cinnamon and its compounds may have beneficial effects on CKD-related complications 2, 3, 4, 5.
Possible Mechanisms
- The bioactive compounds in cinnamon, such as cinnamaldehyde, cinnamic acid, and cinnamate, may mitigate oxidative stress, inflammation, hyperglycemia, gut dysbiosis, and dyslipidemia, which are common complications in patients with CKD 2.
- Trans-cinnamic acid may alleviate high-fat diet-induced renal injury via the JNK/ERK/P38 MAPK pathway 3.
- Cinnamon may have multiple health benefits, including hypoglycaemic activity, anti-microbial, anti-fungal, antiviral, antioxidant, anti-tumour, blood pressure-lowering, cholesterol and lipid-lowering, and gastro-protective properties 4.
CKD Management
- Optimal management of CKD includes cardiovascular risk reduction, treatment of albuminuria, avoidance of potential nephrotoxins, and adjustments to drug dosing 6.
- Patients with CKD require monitoring for complications, such as hyperkalemia, metabolic acidosis, hyperphosphatemia, vitamin D deficiency, secondary hyperparathyroidism, and anemia 6.