Nutritional Strategies Against Diabetic Nephropathy: Insights from Animal Studies and Human Trials

Overview

Journal Nutrients

Date 2024 Jun 27

PMID 38931271

Authors

Jiayi Zhou

Nora Franceschini

W H Davin Townley-Tilson

Nobuyo Maeda-Smithies

Affiliations

Soon will be listed here.

Abstract

Diabetic nephropathy (DN), defined as continuously elevated urinary albumin and a diminished estimated glomerular filtration rate, is a serious complication of both type 1 diabetes and type 2 diabetes and is the main cause of end-stage kidney disease. Patients with end-stage renal disease require chronic kidney dialysis and/or a kidney transplantation. Research highlights the role of diet in modulating specific signaling pathways that are instrumental in the progression of DN. Nutrient-sensitive pathways, affected by nutritional compounds and dietary components, offer a novel perspective on the management of DN by influencing inflammation, oxidative stress, and nutrient metabolism. Animal models have identified signaling pathways related to glucose metabolism, inflammation responses, autophagy, and lipid metabolism, while human population studies have contributed to the clinical significance of designing medical and nutritional therapies to attenuate DN progression. Here, we will update recent progress in research into the renoprotective or therapeutic effects of nutritional compounds, and potential nutrition-modulated pathways.

References

Tamadon M, Zahmatkesh M, Beladi Mousavi S . Administration of antioxidants in chronic kidney disease. J Nephropharmacol. 2017; 4(1):9-11. PMC: 5297480. View

Quianzon C, Cheikh I . History of insulin. J Community Hosp Intern Med Perspect. 2013; 2(2). PMC: 3714061. DOI: 10.3402/jchimp.v2i2.18701. View

Cao Y, Lin J, Hammes H, Zhang C . Flavonoids in Treatment of Chronic Kidney Disease. Molecules. 2022; 27(7). PMC: 9000519. DOI: 10.3390/molecules27072365. View

Atoh K, Itoh H, Haneda M . Serum indoxyl sulfate levels in patients with diabetic nephropathy: relation to renal function. Diabetes Res Clin Pract. 2008; 83(2):220-6. DOI: 10.1016/j.diabres.2008.09.053. View

Barutta F, Bellini S, Gruden G . Mechanisms of podocyte injury and implications for diabetic nephropathy. Clin Sci (Lond). 2022; 136(7):493-520. PMC: 9008595. DOI: 10.1042/CS20210625. View

Ahmadi N, Mortazavi M, Iraj B, Askari G . Whether vitamin D3 is effective in reducing proteinuria in type 2 diabetic patients?. J Res Med Sci. 2013; 18(5):374-7. PMC: 3810568. View

Cani P, Neyrinck A, Fava F, Knauf C, Burcelin R, Tuohy K . Selective increases of bifidobacteria in gut microflora improve high-fat-diet-induced diabetes in mice through a mechanism associated with endotoxaemia. Diabetologia. 2007; 50(11):2374-83. DOI: 10.1007/s00125-007-0791-0. View

Zhou Y, Tao H, Xu N, Zhou S, Peng Y, Zhu J . Chrysin improves diabetic nephropathy by regulating the AMPK-mediated lipid metabolism in HFD/STZ-induced DN mice. J Food Biochem. 2022; 46(12):e14379. DOI: 10.1111/jfbc.14379. View

Yang Y, Lei Y, Liang Y, Fu S, Yang C, Liu K . Vitamin D protects glomerular mesangial cells from high glucose-induced injury by repressing JAK/STAT signaling. Int Urol Nephrol. 2021; 53(6):1247-1254. PMC: 8144147. DOI: 10.1007/s11255-020-02728-z. View

10.

Zong G, Liu G, Willett W, Wanders A, Alssema M, Zock P . Associations Between Linoleic Acid Intake and Incident Type 2 Diabetes Among U.S. Men and Women. Diabetes Care. 2019; 42(8):1406-1413. PMC: 6647042. DOI: 10.2337/dc19-0412. View

11.

Obeid W, Hiremath S, Topf J . Protein Restriction for CKD: Time to Move On. Kidney360. 2022; 3(9):1611-1615. PMC: 9528378. DOI: 10.34067/KID.0001002022. View

12.

Kotake Y, Karashima S, Kawakami M, Hara S, Aono D, Konishi S . Impact of salt intake on urinary albumin excretion in patients with type 2 diabetic nephropathy: a retrospective cohort study based on a generalized additive model. Endocr J. 2021; 69(5):577-583. DOI: 10.1507/endocrj.EJ21-0447. View

13.

Cai K, Ma Y, Cai F, Huang X, Xiao L, Zhong C . Changes of gut microbiota in diabetic nephropathy and its effect on the progression of kidney injury. Endocrine. 2022; 76(2):294-303. DOI: 10.1007/s12020-022-03002-1. View

14.

Li Z, Guo H, Li J, Ma T, Zhou S, Zhang Z . Sulforaphane prevents type 2 diabetes-induced nephropathy via AMPK-mediated activation of lipid metabolic pathways and Nrf2 antioxidative function. Clin Sci (Lond). 2020; 134(18):2469-2487. DOI: 10.1042/CS20191088. View

15.

Li Y, Kong J, Wei M, Chen Z, Liu S, Cao L . 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest. 2002; 110(2):229-38. PMC: 151055. DOI: 10.1172/JCI15219. View

16.

Laplante M, Sabatini D . mTOR signaling in growth control and disease. Cell. 2012; 149(2):274-93. PMC: 3331679. DOI: 10.1016/j.cell.2012.03.017. View

17.

Ikizler T . Dietary protein restriction in CKD: the debate continues. Am J Kidney Dis. 2009; 53(2):189-91. DOI: 10.1053/j.ajkd.2008.12.014. View

18.

Kamper A, Strandgaard S . Long-Term Effects of High-Protein Diets on Renal Function. Annu Rev Nutr. 2017; 37:347-369. DOI: 10.1146/annurev-nutr-071714-034426. View

19.

Senyigit A . The association between 25-hydroxy vitamin D deficiency and diabetic complications in patients with type 2 diabetes mellitus. Diabetes Metab Syndr. 2019; 13(2):1381-1386. DOI: 10.1016/j.dsx.2019.01.043. View

20.

Kakoki M, Bahnson E, Hagaman J, Siletzky R, Grant R, Kayashima Y . Engulfment and cell motility protein 1 potentiates diabetic cardiomyopathy via Rac-dependent and Rac-independent ROS production. JCI Insight. 2019; 4(12). PMC: 6629098. DOI: 10.1172/jci.insight.127660. View