Over 10% of the adult population suffer from chronic kidney disease (CKD). The two leading underlying causes of end-stage kidney disease are due to type II diabetes and hypertension. There can also be a dysbiosis of the gut microbiome along with inflammation that can play a role as well.

According to a new study published this month in Clinical Journal of the American Society of Nephrology, researchers investigated the effect of resveratrol on endothelial function in patients with CKD and diabetes.

This randomized, double-blind, placebo-controlled, crossover study consisted of 23 adults with a mean age of 68 and 84% were men with stage 3 CKD and diabetes. This study investigated the effect of resveratrol supplementation at 400 mg daily on endothelial function. Endothelial function was determined via brachial artery flow-mediated dilation.

Brachial artery flow-mediated dilation is a measure of endothelium-dependent dilation in response to an acute increase in shear stress stimulus following prolonged occlusion and is largely dependent on the production of nitric oxide by endothelial nitric oxide synthase (eNOS). This eNOS activity and/or nitric oxide bioavailability is impaired when the endothelium is exposed to elevated levels of oxidative stress and inflammation.

As a result, resveratrol supplementation increased flow-mediated dilation compared to the placebo demonstrating that the supplementation improved endothelial function. Other biomarkers including eGFR, HbA1c, blood pressure, and nitroglycerin-mediated dilation were unchanged suggesting that the change in flow-mediated dilation was likely independent of changes in traditional cardiovascular risk factors.

Other nutrients to consider include fiber, resistant starch, fish oil, phosphatidylcholine, and n-acetyl-cysteine or glutathione.

Previous research has demonstrated that a high fiber diet can mitigate disease severity and kidney dysfunction in patients with CKD. Higher dietary fiber intake is linked to better kidney function and lower risk of inflammation and mortality.

Fish oil supplementation has been shown to decrease protein in the urine as well as protect kidney function and slow the rate of kidney dysfunction. Doses up to 10 grams per day have been used.

In addition, providing phospholipids such as phosphatidylcholine supports cell membrane regeneration as decrease the body burden of xenobiotics.

Each person’s biochemical individuality exerts a major influence on his or her health. The level of nutrient intake, lifestyle choices and environmental exposures filtered through genetic predisposition are major factors in the expression of disease, and a successful treatment approach must investigate these factors.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Gimblet C, Krus N, et al. Effect of Resveratrol on Endothelial Function in Patients with CKD and Diabetes: A Randomized Controlled Trial. Clin J Am Nephrol. 2023 Oct 16.

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