I noticed that EC could use more remedies for Chronic Kidney Disease, so I am adding four new ones to the list: Sodium Bicarbonate, fruits and vegetables, Melatonin, and Fish Oil.

Chronic Kidney disease (CKD) is very common, with more than 1 in 7 or 15% of US adults having CKD, and 9 of 10 adults with CKD are not even aware that they have it.

https://www.cdc.gov/kidneydisease/publications-resources/ckd-national-facts.html#:~:text=CKD Is Common Among US Adults&text=More than 1 in 7, are estimated to have CKD.&text=As many as 9 in, not know they have CKD.

Here is a quote from this CDC article:

• More than 1 in 7, that is 15% of US adults or 37 million people, are estimated to have CKD.*
• As many as 9 in 10 adults with CKD do not know they have CKD.
• About 2 in 5 adults with severe CKD do not know they have CKD.

What Causes CKD?

Diabetes and High Blood Pressure are the most common causes of CKD.

https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/causes#:~:text=Diabetes and high blood pressure, type of treatment you receive.

Other causes of CKD include the following:

• A genetic disorder that causes many cysts to grow in the kidneys is polycystic kidney disease (PKD).
• an infection
• a drug that is toxic to the kidneys
• a disease that affects the entire body, such as diabetes or lupus nephritis NIH externalis the medical name for kidney disease caused by lupus
• IgA glomerulonephritis
• disorders in which the body’s immune system attacks its own cells and organs, such as Anti-GBM (Goodpasture's) disease
• heavy metal poisoning, such as lead poisoning NIH external link
• rare genetic conditions, such as Alport syndrome NIH external link
• hemolytic uremic syndrome in children
• IgA vasculitis
• renal artery stenosis

How Serious is CKD?

CKD can range from a mild condition with no or few symptoms to a very serious condition where the kidneys stop working, sometimes called kidney failure.

Most people with CKD will be able to control their condition with medicine and regular check-ups. CKD only progresses to kidney failure in around 1 in 50 people with the condition

https://www.nhs.uk/conditions/kidney-disease/#:~:text=CKD can range from a medicine and regular check-ups.

What are the Signs and Symptoms of CKD?

Later stages of CKD

Several symptoms can develop if kidney disease is not found early or it worsens despite treatment.

Symptoms can include:

• weight loss and poor appetite
• swollen ankles, feet or hands – as a result of water retention, edema
• shortness of breath
• tiredness
• blood in your urine
• an increased need to urinate – particularly at night
• difficulty sleeping /insomnia
• itchy skin
• muscle cramps
• feeling sick
• headaches
• erectile dysfunction in men

This stage of CKD is known as kidney failure, end-stage renal disease, or established renal failure. It may eventually require treatment with dialysis.

https://www.nhs.uk/conditions/kidney-disease/symptoms/

Sodium Bicarbonate (Baking Soda)

One of the simplest remedies that work against CKD and can slow progression is Sodium Bicarbonate, as outlined in the following study:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736774/

Here is a relevant quote from the study:

This is the first randomized, controlled clinical study in which oral sodium bicarbonate supplementation was associated with positive effects in both primary and secondary endpoints in patients with CKD. Sodium bicarbonate supplementation slowed the rate of decline of renal function as assessed by CrCl to 1 ml/min per yr compared with >2.5 ml/min per yr in untreated control patients. It also significantly reduced the number of patients who progressed to ESRD. These beneficial effects were clinically meaningful. The adverse event profile of both groups was similar. The anticipated adverse effects of sodium bicarbonate supplementation were worsening hypertension and edema as a result of sodium retention. There was no effect on BP or evidence of worsening edema as assessed clinically at every clinic consultation. 

Fruits and Vegetables

In the following study, it is shown that fruit and vegetables, as well as Sodium Bicarbonate, are both helpful in reducing metabolic acidosis in CKD. Since both were effective at decreasing kidney damage and work through different methods of action, the two combined may have synergy to fight CKD. Unfortunately, they did not include a third arm to the study that received both simultaneously to determine whether they have synergy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586961/

Here is a useful quote from the study:

Plasma cystatin C–calculated eGFR did not differ at baseline and 1 year between groups. One-year PTCO2 was higher than baseline in the HCO3 group (21.2±1.3 versus 19.5±1.5 mM; P<0.01) and the fruits and vegetables group (19.9±1.7 versus 19.3±1.9 mM; P<0.01), consistent with improved metabolic acidosis, and was higher in the HCO3 than the fruits and vegetable group (P<0.001). One-year urine indices of kidney injury were lower than baseline in both groups. Plasma [K+] did not increase in either group. 

This November 2020 study further confirms Sodium Bicarbonate's value in the treatment of CKD. It attempts to evaluate its different methods of action that are beneficial for CKD as well as for acidosis:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7792697/

Here is a relevant quote from the study:

Both clinical and basic science research has demonstrated beneficial effects of NaHCO3 on slowing kidney functional decline. A number of potential pathways through which alkali loading may protect the kidney, including both renal compensatory responses and extrarenal mechanisms, have been identified.

Melatonin

Another beneficial supplement that I have mentioned before as being useful for multiple health conditions, including CKD is melatonin, as discussed in the following study:

https://www.nature.com/articles/s41440-018-0186-2

Here is an important quote from the study:

The intrarenal renin-angiotensin system (RAS) is one of the most important contributors in the pathophysiology of chronic kidney disease (CKD) and hypertension, independent of the circulating RAS, due to sodium reabsorption and inflammation and fibrosis in the kidney. However, the relationship between melatonin secretion and intrarenal RAS activation has remained unknown. It has been recently shown that impaired nighttime melatonin secretion is associated with nighttime urinary angiotensinogen excretion, a surrogate marker of intrarenal RAS activation and renal damage in patients with CKD. Moreover, it has also been indicated that melatonin administered exogenously exercises antioxidant effects that ameliorate intrarenal RAS activation and renal injury in chronic progressive CKD animal models. As a result, the new roles of melatonin in suppressing RAS in the kidney via amelioration of reactive oxygen species have been clarified. Therefore, we review the relationship between melatonin and intrarenal RAS activation and indicate the possibility of a new strategy to suppress CKD, which is a risk factor for cardiovascular and end-stage renal diseases. 

The following rat study suggests that melatonin may reduce CKD-related hypertension, which could be considered a negative health cycle that melatonin may ameliorate. Very interestingly, it is thought that melatonin can do this via gut microbiome manipulation!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8388963/

Here is a relevant quote from the study:

In this first adenine-induced pediatric CKD model, melatonin protected young rats from CKD-induced hypertension related to alterations of gut microbes involved in the TMA–TMAO pathway. The ADMA–NO pathway was also involved in CKD-induced hypertension. Providing a greater understanding of the alterations of gut microbiota and the derived metabolites that underlie CKD-induced hypertension, along with the beneficial effects of melatonin on protection from hypertension, our results can aid in preventing childhood hypertension and CKD progression. 

Fish Oil for CKD

I will discuss one more significant consideration for CKD: Fish Oil (FO).

In the following study, it is suggested that FO may be beneficial when it comes to CKD: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5251198/#:~:text=In sum, omega-3 fatty, the progression of this disease.

Here is a relevant quote from the meta-analysis, and being a meta-analysis, it carries a bit more weight than just an individual study:

In sum, omega-3 fatty acid supplementation is associated with a significantly reduced risk of end-stage renal disease and delays the progression of this disease. 

In the following study, it is determined that FO reduces the pruritus (itchy skin) that is often seen in CKD, as well as associated inflammation:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9229849/

Here is a relevant quote from the study:

Omega-3 PUFA supplementation improved inflammation, renal function, cardiovascular parameters, dry skin conditions, and the consequent symptoms of pruritus in hemodialysis patients. 

It is important to note in the above study that these patients are already on dialysis.

In this last study regarding FO and CKD, they reach a very interesting conclusion that seems enticing toward the use of FO for CKD:

https://www.karger.com/Article/Abstract/520027

Here is a relevant quote from the study:

There may be an inverse relation between dietary omega-3 PUFA intake and all-cause mortality in patients with CKD. Therefore, an increase in dietary omega-3 PUFA may be encouraged for clinical use in patients with CKD. 

So, these are four options for consideration in CKD, which I would like to add to the Earth Clinic's list of remedies. There are others worth consideration, but these four are inexpensive, readily available over the counter, and have shown themselves to be active or useful against CKD and related health issues in studies. At the same time, all four have very good safety profiles.

Art