Skip to main content

Advertisement

SpringerLink
Log in

Nutrition, Immunology, and Kidney: Looking Beyond the Horizons

  • Functional Foods (I Rudkowska, Section Editor)
  • Published:
Current Nutrition Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Chronic kidney disease (CKD) is epidemic throughout the word. Despite various novel therapeutic opportunities, CKD is still associated with high morbidity and mortality. In CKD, patient’s chronic inflammation is frequent and related with adverse outcomes. Both innate and adaptive immunity are dysfunctional in CKD. Therefore, it is plausible to interfere with dysfunctional immunity in these patients. In the current review, we present the updated experimental and clinical data summarizing the effects of nutritional interventions including natural products and dietary supplements on immune dysfunction in the context of CKD.

Recent Findings

Nutritional interventions including natural products and dietary supplements (e.g., curcumin, sulforaphane, resistant starch, anthocyanin, chrysin, short chain fatty acids, fish oil resistant starch) slow down the inflammation by at least 6 mechanisms: (i) decrease nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB); (ii) decrease NLR family pyrin domain containing 3 (NLRP3); (iii) decrease interleukin-1 (IL-1), decrease interleukin-6 (IL-6) secretion; (iv) decrease polymorphonuclear priming); (v) promote anti-inflammatory pathways (nuclear factor-erythroid factor 2-related factor 2 (NFR2); (vi) increase T regulatory (Tregs) cells).

Summary

Natural products and dietary supplements may provide benefit in terms of kidney health. By modulation of nutritional intake, progression of CKD may be delayed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Amdur RL, Feldman HI, Gupta J, Yang W, Kanetsky P, Shlipak M, et al. Inflammation and progression of CKD: the CRIC Study. Clin J Am Soc Nephrol. 2016;11:1546–56.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. •• Losappio V, Infante B, Leo S, Troise D, Calvaruso M, Vitale P, et al. Nutrition-based management of inflammaging in CKD and renal replacement therapies. Nutrients. 2021;13:267. This review summarises the impact of Western diet on inflammation and explains how mediterranean diet is helpful in decreasing inflammation.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Pedruzzi LM, Cardozo LFMF, Daleprane JB, Stockler-Pinto MB, Monteiro EB, Leite M, et al. Systemic inflammation and oxidative stress in hemodialysis patients are associated with down-regulation of Nrf2. J Nephrol. 2015;28:495–501.

    Article  CAS  PubMed  Google Scholar 

  4. • Espi M, Koppe L, Fouque D, Thaunat O. Chronic kidney disease-associated immune dysfunctions: impact of protein-bound uremic retention solutes on immune cells. Toxins. 2020;12. This review explains the relationship between immune dysfunctions with the accumulation of microbiota-derived metabolites in the context of CKD.

  5. •• Mafra D, Borges NA, Lindholm B, Shiels PG, Evenepoel P, Stenvinkel P. Food as medicine: targeting the uraemic phenotype in chronic kidney disease. Nat Rev Nephrol. 2021;17:153–71. This review summarises how healthy diets and bioactive nutrients could potentially be used to prevent and treat CKD.

    Article  PubMed  Google Scholar 

  6. Kim H, Caulfield LE, Garcia-Larsen V, Steffen LM, Grams ME, Coresh J, et al. Plant-based diets and incident CKD and kidney function. Clin J Am Soc Nephrol. 2019;14:682–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Khatri M, Moon YP, Scarmeas N, Gu Y, Gardener H, Cheung K, et al. The association between a Mediterranean-style diet and kidney function in the Northern Manhattan Study cohort. Clin J Am Soc Nephrol. 2014;9:1868–75.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Rebholz CM, Crews DC, Grams ME, Steffen LM, Levey AS, Miller ER 3rd, et al. DASH (dietary approaches to stop hypertension) diet and risk of subsequent kidney disease. Am J Kidney Dis. 2016;68:853–61.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Lauretani F, Semba RD, Bandinelli S, Miller ER 3rd, Ruggiero C, Cherubini A, et al. Plasma polyunsaturated fatty acids and the decline of renal function. Clin Chem. 2008;54:475–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Kielar ML, Jeyarajah DR, Zhou XJ, Lu CY. Docosahexaenoic acid ameliorates murine ischemic acute renal failure and prevents increases in mRNA abundance for both TNF-α and inducible nitric oxide synthase. J Am Soc Nephrol. 2003;14:389–96.

    Article  CAS  PubMed  Google Scholar 

  11. Haring B, Selvin E, Liang M, Coresh J, Grams ME, Petruski-Ivleva N, et al. Dietary protein sources and risk for incident chronic kidney disease: results from the atherosclerosis risk in communities (ARIC) study. J Ren Nutr. 2017;27:233–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Ali BH, Adham SA, Al Za’abi M, Waly MI, Yasin J, Nemmar A, et al. Ameliorative effect of chrysin on adenine-induced chronic kidney disease in rats. PloS one. 2015;10:e0125285.

  13. Sumida K, Lau WL, Kovesdy CP, Kalantar-Zadeh K, Kalantar-Zadeh K. Microbiome modulation as a novel therapeutic approach in chronic kidney disease. Curr Opin Nephrol Hypertens. 2021;30:75–84.

    Article  CAS  PubMed  Google Scholar 

  14. •  González-Ortiz A, Xu H, Avesani CM, Lindholm B, Cederholm T, Risérus U, et al. Plant-based diets, insulin sensitivity and inflammation in elderly men with chronic kidney disease. J Nephrol. 2020;33:1091–101. This study showed that in CKD stages 3-5, adherence to a plant-based diet was associated with higher insulin sensitivity and lower inflammation, supporting a possible role of plant-based diets in the prevention of metabolic complications of CKD.

  15. Xu H, Huang X, Risérus U, Krishnamurthy VM, Cederholm T, Arnlöv J, et al. Dietary fiber, kidney function, inflammation, and mortality risk. Clin J Am Soc Nephrol. 2014;9:2104–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Oppelaar JJ, Vogt L. Body fluid-independent effects of dietary salt consumption in chronic kidney disease. Nutrients. 2019;11.

  17. Wade B, Abais-Battad JM, Mattson DL. Role of immune cells in salt-sensitive hypertension and renal injury. Curr Opin Nephrol Hypertens. 2016;25:22–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Knauf F, Brewer JR, Flavell RA. Immunity, microbiota and kidney disease. Nat Rev Nephrol. 2019;15:263–74.

    Article  PubMed  Google Scholar 

  19. Lang C-L, Wang M-H, Chiang C-K, Lu K-C. Vitamin D and the immune system from the nephrologist's viewpoint. ISRN Endocrinol. 2014;2014:105456.

  20. • Cardozo L, Alvarenga LA, Ribeiro M, Dai L, Shiels PG, Stenvinkel P, et al. Cruciferous vegetables: rationale for exploring potential salutary effects of sulforaphane-rich foods in patients with chronic kidney disease. Nutr Rev. 2020;79:1204–24. This review summarises the potential benefits of Sulforaphane in CKD.

    Article  Google Scholar 

  21. Alvarenga L, Cardozo L, Borges NA, Lindholm B, Stenvinkel P, Shiels PG, et al. Can nutritional interventions modulate the activation of the NLRP3 inflammasome in chronic kidney disease?. Food Res Int. 2020;136:109306.

  22. Shan Q, Zheng Y, Lu J, Zhang Z, Wu D, Fan S, et al. Purple sweet potato color ameliorates kidney damage via inhibiting oxidative stress mediated NLRP3 inflammasome activation in high fat diet mice. Food Chem Toxicol. 2014;69:339–46.

    Article  CAS  PubMed  Google Scholar 

  23. Ka SM, Kuoping Chao L, Lin JC, Chen ST, Li WT, Lin CN, et al. A low toxicity synthetic cinnamaldehyde derivative ameliorates renal inflammation in mice by inhibiting NLRP3 inflammasome and its related signaling pathways. Free Radic Biol Med. 2016;91:10–24.

    Article  CAS  PubMed  Google Scholar 

  24. Bugyei-Twum A, Abadeh A, Thai K, Zhang Y, Mitchell M, Kabir G, et al. Suppression of NLRP3 inflammasome activation ameliorates chronic kidney disease-induced cardiac fibrosis and diastolic dysfunction. Sci Rep. 2016;6:39551.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Zhao J, Wang J, Zhou M, Li M, Li M, Tan H. Curcumin attenuates murine lupus via inhibiting NLRP3 inflammasome. Int Immunopharmacol. 2019;69:213–6.

    Article  CAS  PubMed  Google Scholar 

  26. Lin YF, Lee YH, Hsu YH, Chen YJ, Lin YF, Cheng FY, et al. Resveratrol-loaded nanoparticles conjugated with kidney injury molecule-1 as a drug delivery system for potential use in chronic kidney disease. Nanomedicine. 2017;12:2741–56.

    Article  CAS  PubMed  Google Scholar 

  27. Chen Y-H, Fu Y-C, Wu M-J. Does resveratrol play a role in decreasing the inflammation associated with contrast induced nephropathy in rat model? J Clin Med. 2019;8:147.

    Article  CAS  PubMed Central  Google Scholar 

  28. He J, Sun M, Tian S. Procyanidin B2 prevents lupus nephritis development in mice by inhibiting NLRP3 inflammasome activation. Innate Immun. 2018;24:307–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Stockler-Pinto MB, Mafra D, Moraes C, Lobo J, Boaventura GT, Farage NE, et al. Brazil nut (Bertholletia excelsa, H.B.K.) improves oxidative stress and inflammation biomarkers in hemodialysis patients. Biol Trace Elem Res. 2014;158:105–12.

    Article  CAS  PubMed  Google Scholar 

  30. Janiques AG, Leal Vde O, Stockler-Pinto MB, Moreira NX, Mafra D. Effects of grape powder supplementation on inflammatory and antioxidant markers in hemodialysis patients: a randomized double-blind study. J Bras Nefrol. 2014;36:496–501.

    Article  PubMed  Google Scholar 

  31. Biswas C, Shah N, Muthu M, La P, Fernando AP, Sengupta S, et al. Nuclear heme oxygenase-1 (HO-1) modulates subcellular distribution and activation of Nrf2 impacting metabolic and anti-oxidant defenses. J Biol Chem. 2014;289:26882–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Wang Y, Wang B, Du F, Su X, Sun G, Zhou G, et al. Epigallocatechin-3-gallate attenuates oxidative stress and inflammation in obstructive nephropathY via NF-κB and Nrf2/HO-1 signalling pathway regulation. Basic Clin Pharmacol Toxicol. 2015;117:164–72.

    Article  CAS  PubMed  Google Scholar 

  33. Saldanha JF, Leal VO, Rizzetto F, Grimmer GH, Ribeiro-Alves M, Daleprane JB, et al. Effects of resveratrol supplementation in Nrf2 and NF-κB expressions in nondialyzed chronic kidney disease patients: a randomized double-blind placebo-controlled crossover clinical triaL. J Ren Nutr. 2016;26:401–6.

    Article  CAS  PubMed  Google Scholar 

  34. Ruiz S, Pergola PE, Zager RA, Vaziri ND. Targeting the transcription factor Nrf2 to ameliorate oxidative stress and inflammation in chronic kidney disease. Kidney Int. 2013;83:1029–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Wu CC, Huang YS, Chen JS, Huang CF, Su SL, Lu KC, et al. Resveratrol ameliorates renal damage, increases expression of heme oxygenase-1, and has anti-complement, anti-oxidative, and anti-apoptotic effects in a murine model of membranous nephropathy. PloS one. 2015;10:e0125726.

  36. Cardozo LFMF, Stockler-Pinto MB, Mafra D. Brazil nut consumption modulates Nrf2 expression in hemodialysis patients: A pilot study. Mol Nutr Food Res. 2016;60:1719–24.

    Article  CAS  PubMed  Google Scholar 

  37. Shokeir AA, Barakat N, Hussein AM, Awadalla A, Harraz AM, Khater S, et al. Activation of Nrf2 by ischemic preconditioning and sulforaphane in renal ischemia/reperfusion injury: a comparative experimental study. Physiol Res. 2015;64:313–23.

    Article  CAS  PubMed  Google Scholar 

  38. Shih JM, Shih YM, Pai MH, Hou YC, Yeh CL, Yeh SL. Fish oil-based fat emulsion reduces acute kidney injury and inflammatory response in antibiotic-treated polymicrobial septic mice. Nutrients. 2016;8:165.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Calder PC. n-3 polyunsaturated fatty acids inflammation and inflammatory diseases. Am J Clin Nutr. 2006;83:1505s–19s.

    Article  CAS  PubMed  Google Scholar 

  40. Caughey GE, Mantzioris E, Gibson RA, Cleland LG, James MJ. The effect on human tumor necrosis factor alpha and interleukin 1 beta production of diets enriched in n-3 fatty acids from vegetable oil or fish oil. Am J Clin Nutr. 1996;63:116–22.

    Article  CAS  PubMed  Google Scholar 

  41. Vaziri ND, Liu S-M, Lau WL, Khazaeli M, Nazertehrani S, Farzaneh SH, et al. High amylose resistant starch diet ameliorates oxidative stress inflammation and progression of chronic kidney disease. PloS one. 2014;9:e114881.

  42. Esgalhado M, Kemp JA, Azevedo R, Paiva BR, Stockler-Pinto MB, Dolenga CJ, et al. Could resistant starch supplementation improve inflammatory and oxidative stress biomarkers and uremic toxins levels in hemodialysis patients? A pilot randomized controlled trial. Food Funct. 2018;9:6508–16.

    Article  CAS  PubMed  Google Scholar 

  43. Tayebi Khosroshahi H, Vaziri ND, Abedi B, Asl BH, Ghojazadeh M, Jing W, et al. Effect of high amylose resistant starch (HAM-RS2) supplementation on biomarkers of inflammation and oxidative stress in hemodialysis patients: a randomized clinical trial. Hemodial Int. 2018;22:492–500.

    Article  PubMed  Google Scholar 

  44. •• Nobs SP, Zmora N, Elinav E. Nutrition regulates innate immunity in health and disease. Annu Rev Nutr. 2020;40:189–219. This review summarized the interactions between innate immunity and diet affect human metabolic health and disease.

    Article  CAS  PubMed  Google Scholar 

  45. Lee H, Fessler MB, Qu P, Heymann J, Kopp JB. Macrophage polarization in innate immune responses contributing to pathogenesis of chronic kidney disease. BMC Nephrol. 2020;21:270.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Oh DY, Talukdar S, Bae EJ, Imamura T, Morinaga H, Fan W, et al. GPR120 is an omega-3 fatty acid receptor mediating potent anti-inflammatory and insulin-sensitizing effects. Cell. 2010;142:687–98.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Sela S, Shurtz-Swirski R, Cohen-Mazor M, Mazor R, Chezar J, Shapiro G, et al. Primed peripheral polymorphonuclear leukocyte: a culprit underlying chronic low-grade inflammation and systemic oxidative stress in chronic kidney disease. J Am Soc Nephrol. 2005;16:2431–8.

    Article  CAS  PubMed  Google Scholar 

  48. Shema-Didi L, Kristal B, Ore L, Shapiro G, Geron R, Sela S. Pomegranate juice intake attenuates the increase in oxidative stress induced by intravenous iron during hemodialysis. Nutr Res. 2013;33:442–6.

    Article  CAS  PubMed  Google Scholar 

  49. Thomas S, Izard J, Walsh E, Batich K, Chongsathidkiet P, Clarke G, et al. The host microbiome regulates and maintains human health: a primer and perspective for non-microbiologists. Cancer Res. 2017;77:1783–812.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Kinsey GR, Sharma R, Okusa MD. Regulatory T Cells in AKI. J Am Soc Nephrol. 2013;24:1720–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Sharma R, Kinsey GR. Regulatory T cells in acute and chronic kidney diseases. Am J Physiol Renal Physiol. 2018;314:F679–98.

    Article  PubMed  Google Scholar 

  52. Cani PD, Knauf C. How gut microbes talk to organs: the role of endocrine and nervous routes. Mol Metab. 2016;5:743–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Kim CH, Park J, Kim M. Gut microbiota-derived short-chain fatty acids, T cells, and inflammation. Immune Netw. 2014;14:277–88.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Wei B, Wingender G, Fujiwara D, Chen DY, McPherson M, Brewer S, et al. Commensal microbiota and CD8+ T cells shape the formation of invariant NKT cells. J Immunol. 2010;184:1218–26.

    Article  CAS  PubMed  Google Scholar 

  55. Corrêa-Oliveira R, Fachi JL, Vieira A, Sato FT, Vinolo MAR. Regulation of immune cell function by short-chain fatty acids. Clin Transl Immunol. 2016;5:e73.

  56. Smith PM, Howitt MR, Panikov N, Michaud M, Gallini CA, Bohlooly YM, et al. The microbial metabolites, short-chain fatty acids, regulate colonic Treg cell homeostasis. Science. 2013;341:569–73.

    Article  CAS  PubMed  Google Scholar 

  57. Stenvinkel P. Inflammatory and atherosclerotic interactions in the depleted uremic patient. Blood Purif. 2001;19:53–61.

    Article  CAS  PubMed  Google Scholar 

  58. Shing CM, Adams MJ, Fassett RG, Coombes JS. Nutritional compounds influence tissue factor expression and inflammation of chronic kidney disease patients in vitro. Nutrition. 2011;27:967–72.

    Article  CAS  PubMed  Google Scholar 

  59. Azadbakht L, Atabak S, Esmaillzadeh A. Soy protein intake, cardiorenal indices, and C-reactive protein in type 2 diabetes with nephropathy: a longitudinal randomized clinical trial. Diabetes Care. 2008;31:648–54.

    Article  CAS  PubMed  Google Scholar 

  60. Bowden RG, Wilson RL, Deike E, Gentile M. Fish oil supplementation lowers C-reactive protein levels independent of triglyceride reduction in patients with end-stage renal disease. Nutr Clin Pract. 2009;24:508–12.

    Article  PubMed  Google Scholar 

  61. Xie LM, Ge YY, Huang X, Zhang YQ, Li JX. Effects of fermentable dietary fiber supplementation on oxidative and inflammatory status in hemodialysis patients. Int J Clin Exp Med. 2015;8:1363–9.

    PubMed  PubMed Central  Google Scholar 

  62. Ghosh SS, Massey HD, Krieg R, Fazelbhoy ZA, Ghosh S, Sica DA, et al. Curcumin ameliorates renal failure in 5/6 nephrectomized rats: role of inflammation. Am J Physiol Renal Physiol. 2009;296:F1146–57.

    Article  CAS  PubMed  Google Scholar 

  63. El Gamal AA, AlSaid MS, Raish M, Al-Sohaibani M, Al-Massarani SM, Ahmad A, et al. Beetroot (Beta vulgaris L.) extract ameliorates gentamicin-induced nephrotoxicity associated oxidative stress, inflammation, and apoptosis in rodent model. Mediators Inflamm. 2014;2014:983952.

  64. Ali BH, Al-Salam S, Al Suleimani Y, Al Kalbani J, Al Bahlani S, Ashique M, et al. Curcumin ameliorates kidney function and oxidative stress in experimental chronic kidney disease. Basic Clin Pharmacol Toxicol. 2018;122:65–73.

    Article  CAS  PubMed  Google Scholar 

  65. Hou Y-C, Wu J-M, Chen K-Y, Chen P-D, Lei C-S, Yeh S-L, et al. Effects of prophylactic administration of glutamine on CD4+ T cell polarisation and kidney injury in mice with polymicrobial sepsis. Br J Nutr. 2019;122:657–65.

    Article  CAS  PubMed  Google Scholar 

  66. Zhao W, Zeng X, Meng F, Bi X, Xu D, Chen X, et al. Structural characterization and in vitro-in vivo evaluation of effect of a polysaccharide from Sanguisorba officinalis on acute kidney injury. Food Funct. 2019;10:7142–51.

    Article  CAS  PubMed  Google Scholar 

  67. • He L-X, Abdolmaleky HM, Yin S, Wang Y, Zhou J-R. Dietary fermented soy extract and oligo-lactic acid alleviate chronic kidney disease in mice via inhibition of inflammation and modulation of gut microbiota. Nutrients. 2020;12:2376. This study has shown that fermented soybean product decrease kidney damage and inflamation in experiemental CKD.

    Article  CAS  PubMed Central  Google Scholar 

  68. Khajehdehi P, Pakfetrat M, Javidnia K, Azad F, Malekmakan L, Nasab MH, et al. Oral supplementation of turmeric attenuates proteinuria, transforming growth factor-β and interleukin-8 levels in patients with overt type 2 diabetic nephropathy: a randomized, double-blind and placebo-controlled study. Scand J Urol Nephrol. 2011;45:365–70.

    Article  CAS  PubMed  Google Scholar 

  69. Zhang H, Sun SC. NF-κB in inflammation and renal diseases. Cell Biosci. 2015;5:63.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Guerrero-Beltrán CE, Mukhopadhyay P, Horváth B, Rajesh M, Tapia E, García-Torres I, et al. Sulforaphane, a natural constituent of broccoli, prevents cell death and inflammation in nephropathy. J Nutr Biochem. 2012;23:494–500.

    Article  PubMed  Google Scholar 

  71. Andrade-Oliveira V, Amano MT, Correa-Costa M, Castoldi A, Felizardo RJ, de Almeida DC, et al. Gut bacteria products prevent AKI induced by ischemia-reperfusion. J Am Soc Nephrol. 2015;26:1877–88.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. El Seedy GM, El-Shafey ES, Elsherbiny ES. Fortification of biscuit with sidr leaf and flaxseed mitigates immunosuppression and nephrotoxicity induced by cyclosporine A. J Food Biochem. 2021:e13655.

  73. Machado RA, Constantino Lde S, Tomasi CD, Rojas HA, Vuolo FS, Vitto MF, et al. Sodium butyrate decreases the activation of NF-κB reducing inflammation and oxidative damage in the kidney of rats subjected to contrast-induced nephropathy. Nephrol Dial Transplant. 2012;27:3136–40.

    Article  CAS  PubMed  Google Scholar 

  74. Wu H, Singer J, Kwan TK, Loh YW, Wang C, Tan J, et al. Gut microbial metabolites induce donor-specific tolerance of kidney allografts through induction of T regulatory cells by short-chain fatty acids. J Am Soc Nephrol. 2020;31:1445–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Khosroshahi HT, Abedi B, Ghojazadeh M, Samadi A, Jouyban A. Effects of fermentable high fiber diet supplementation on gut derived and conventional nitrogenous product in patients on maintenance hemodialysis: a randomized controlled trial. Nutr Metab. 2019;16:18.

    Article  Google Scholar 

  76. de Paiva BR, Esgalhado M, Borges NA, Kemp JA, Alves G, Leite PEC, et al. Resistant starch supplementation attenuates inflammation in hemodialysis patients: a pilot study. Int Urol Nephrol. 2020;52:549–55.

    Article  PubMed  Google Scholar 

  77. Kelly JT, Rossi M, Johnson DW, Campbell KL. Beyond sodium, phosphate and potassium: potential dietary interventions in kidney disease. Semin Dial. 2017;30:197–202.

    Article  PubMed  Google Scholar 

  78. Sumida K, Molnar MZ, Potukuchi PK, Thomas F, Lu JL, Yamagata K, et al. Constipation and risk of death and cardiovascular events. Atherosclerosis. 2019;281:114–20.

    Article  CAS  PubMed  Google Scholar 

  79. Luis D, Zlatkis K, Comenge B, García Z, Navarro JF, Lorenzo V, et al. Dietary quality and adherence to dietary recommendations in patients undergoing hemodialysis. J Ren Nutr. 2016;26:190–5.

    Article  PubMed  Google Scholar 

  80. • Fanti P, Asmis R, Stephenson TJ, Sawaya BP, Franke AA. Positive effect of dietary soy in ESRD patients with systemic inflammation–correlation between blood levels of the soy isoflavones and the acute-phase reactants. Nephrol Dial Transplant. 2006;21:2239–46. This study showed that isoflavone-rich soy foods improves nutritional status and decreases inflammation in HD patients.

    Article  CAS  PubMed  Google Scholar 

  81. Siefker K, DiSilvestro RA. Safety and antioxidant effects of a modest soy protein intervention in hemodialysis patients. J Med Food. 2006;9:368–72.

    Article  CAS  PubMed  Google Scholar 

  82. Miraghajani MS, Esmaillzadeh A, Najafabadi MM, Mirlohi M, Azadbakht L. Soy milk consumption, inflammation, coagulation, and oxidative stress among type 2 diabetic patients with nephropathy. Diabetes Care. 2012;35:1981–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. Gharekhani A, Khatami MR, Dashti-Khavidaki S, Razeghi E, Abdollahi A, Hashemi-Nazari SS, et al. Effects of oral supplementation with omega-3 fatty acids on nutritional state and inflammatory markers in maintenance hemodialysis patients. J Ren Nutr. 2014;24:177–85.

    Article  CAS  PubMed  Google Scholar 

  84. Pakfetrat M, Basiri F, Malekmakan L, Roozbeh J. Effects of turmeric on uremic pruritus in end stage renal disease patients: a double-blind randomized clinical trial. J Nephrol. 2014;27:203–7.

    Article  CAS  PubMed  Google Scholar 

  85. Alvarenga L, Salarolli R, Cardozo LFMF, Santos RS, de Brito JS, Kemp JA, et al. Impact of curcumin supplementation on expression of inflammatory transcription factors in hemodialysis patients: A pilot randomized, double-blind, controlled study. Clin Nutr. 2020;39:3594–600.

    Article  CAS  PubMed  Google Scholar 

  86. Shema-Didi L, Sela S, Ore L, Shapiro G, Geron R, Moshe G, et al. One year of pomegranate juice intake decreases oxidative stress, inflammation, and incidence of infections in hemodialysis patients: a randomized placebo-controlled trial. Free Radic Biol Med. 2012;53:297–304.

    Article  CAS  PubMed  Google Scholar 

  87. Wu PT, Fitschen PJ, Kistler BM, Jeong JH, Chung HR, Aviram M, et al. Effects of pomegranate extract supplementation on cardiovascular risk factors and physical function in hemodialysis patients. J Med Food. 2015;18:941–9.

    Article  CAS  PubMed  Google Scholar 

  88. Sirich TL, Plummer NS, Gardner CD, Hostetter TH, Meyer TW. Effect of increasing dietary fiber on plasma levels of colon-derived solutes in hemodialysis patients. Clin J Am Soc Nephrol. 2014;9:1603–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  89. de Andrade LS, Sardá FAH, Pereira NBF, Teixeira RR, Rodrigues SD, de Lima JD, et al. Effect of unripe banana flour on gut-derived uremic toxins in individuals undergoing peritoneal dialysis: a randomized, double-blind, placebo-controlled, crossover trial. Nutrients. 2021;13:646.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Rossi M, Johnson DW, Morrison M, Pascoe EM, Coombes JS, Forbes JM, et al. Synbiotics Easing Renal Failure by Improving Gut Microbiology (SYNERGY): a randomized trial. Clin J Am Soc Nephrol. 2016;11:223–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. Natarajan R, Pechenyak B, Vyas U, Ranganathan P, Weinberg A, Liang P, et al. Randomized controlled trial of strain-specific probiotic formulation (Renadyl) in dialysis patients. BioMed Res Int. 2014;2014:568571.

  92. Mirzaeian S, Saraf-Bank S, Entezari MH, Hekmatdoost A, Feizi A, Atapour A. Effects of synbiotic supplementation on microbiota-derived protein-bound uremic toxins, systemic inflammation, and biochemical parameters in patients on hemodialysis: a double-blind, placebo-controlled, randomized clinical trial. Nutrition. 2020;73:110713.

  93. Rassaf T, Rammos C, Hendgen-Cotta UB, Heiss C, Kleophas W, Dellanna F, et al. Vasculoprotective effects of dietary cocoa flavanols in patients on hemodialysis: a double-blind, randomized, placebo-controlled trial. Clin J Am Soc Nephrol. 2016;11:108–18.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Nephrology, Department of Nephrology, Suleyman Demirel University School of Medicine, Isparta, Turkey

    Baris Afsar & Rengin Elsurer Afsar

  2. Department of Medicine, Koc University School of Medicine, Istanbul, Turkey

    Lale A. Ertuglu

  3. Department of Nephrology, Grigore T. Popa’ University of Medicine, Iasi, Romania

    Adrian Covic

  4. Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey

    Mehmet Kanbay

Authors
  1. Baris Afsar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rengin Elsurer Afsar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lale A. Ertuglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Adrian Covic
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mehmet Kanbay
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Baris Afsar.

Ethics declarations

Conflict of Interest

None declared.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Functional Foods

Supplementary Information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Afsar, B., Afsar, R.E., Ertuglu, L.A. et al. Nutrition, Immunology, and Kidney: Looking Beyond the Horizons. Curr Nutr Rep 11, 69–81 (2022). https://doi.org/10.1007/s13668-021-00388-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13668-021-00388-8

Keywords

Search

Navigation