Polycystic Kidney Disease Diet

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder characterized by kidney cyst formation and progressive kidney function loss. Dietary interventions such as caloric restriction, intermittent fasting, and the ketogenic diet have recently emerged as potential strategies to induce metabolic reprogramming and slow ADPKD progression. We review the available evidence supporting the efficacy and safety of these interventions in ADPKD. Dietary interventions show promise in managing ADPKD by improving metabolic health and reducing oxidative stress. However, while preclinical studies have shown favorable outcomes, limited clinical evidence supports their effectiveness. Also, the long-term consequences of these dietary interventions, including their impact on adverse events in ADPKD patients, remain uncertain. To optimize ADPKD management, patients are advised to follow a dietary regimen that aims to achieve or maintain an ideal weight and includes high fluid intake, low sodium, and limited concentrated sweets. Caloric restriction appears particularly beneficial for individuals with overweight or obesity as it promotes weight loss and improves metabolic parameters. Supplementation with curcumin, ginkgolide B, saponins, vitamin E, niacinamide, or triptolide has demonstrated uncertain clinical benefit in ADPKD patients. Notably, beta-hydroxybutyrate (BHB) supplements have shown promise in animal models; however, their safety and efficacy in ADPKD require further evaluation through well-designed clinical trials. Therefore, the use of these supplements is not currently recommended for ADPKD patients. In summary, dietary interventions such as caloric restriction, intermittent fasting, and the ketogenic diet hold promise in ADPKD management by enhancing metabolic health. However, extensive clinical research is necessary to establish their effectiveness and long-term impacts. Adhering to personalized dietary guidelines, including weight management and specific nutritional restrictions, can contribute to optimal ADPKD management. Future research should prioritize well-designed clinical trials to determine the benefits and safety of dietary interventions and supplementation in ADPKD.

How Does ADPKD Severity Differ Between Family Members?

“…recently provided a comprehensive review on this topic, concluding that further research is required to establish the benefits and safety of these interventions. 54 For now, extrapolating from the available data, and considering the deleterious effects of obesity on cardiovascular disease over and above ADPKD progression, a recommendation of daily caloric restriction is an important part of the nonpharmacologic management of ADPKD.…”

Single-Center Experience of Pediatric Cystic Kidney Disease and Literature Review

“…It is suggested to maintain optimal body weight by limiting consumption of sugary and highly processed foods, increasing fluid intake and regular physical activity, and adhering to a low-sodium diet [99]. The disease progression of ADPKD can be monitored with serial beta-2 microglobulin (β2MG) and monocyte chemotactic protein-1 (MCP-1) [100,101].…”