Jump to ContentJump to Main Navigation
Show Summary Details

Journal of Complementary and Integrative Medicine

Editor-in-Chief: Lui, Edmund

Ed. by Ko, Robert / Leung, Kelvin Sze-Yin / Saunders, Paul / Suntres, PH. D., Zacharias

4 Issues per year


SCImago Journal Rank (SJR) 2015: 0.401
Source Normalized Impact per Paper (SNIP) 2015: 0.429
Impact per Publication (IPP) 2015: 1.255

Online
ISSN
1553-3840
See all formats and pricing

The use of an anti-inflammatory supplement in patients with chronic kidney disease

Jennifer J. Moreillon
  • Corresponding author
  • Baylor University, Waco, TX, United States
  • Email:
/ Rodney G. Bowden
  • Professor of Health Education and Associate Dean for Graduate Studies and Research, Baylor University, Waco, Texas USA
  • Email:
/ Erika Deike
  • Texas Lutheran University, Austin, Texas USA
  • Email:
/ Jackson Griggs
  • Family Health Center
  • Email:
/ Ron Wilson
  • Brazos, Kidney Disease Center
  • Email:
/ Brian Shelmadine
  • Western University of Health Sciences, Pomona, CA 91766, United States
  • Email:
/ Matt Cooke
  • Victoria University, Melbourne, Australia
  • Email:
/ Alexander Beaujean
  • Baylor University, Waco, TX, United States
  • Email:
Published Online: 2013-07-01 | DOI: https://doi.org/10.1515/jcim-2012-0011

Abstract

Chronic kidney disease (CKD) is characterized by a continuous reduction in kidney function, increased inflammation, and reduced antioxidant capacity. The objective of this study was to assess the effects of a herbal supplement on systemic inflammation and antioxidant status in non-dialysis CKD patients. Sixteen patients with CKD (56.0±16.0 yrs, 171.4±11.9 cm, 99.3±20.2 kg) were randomly chosen to receive a herbal supplement composed of Curcuma longa and Boswellia serrata, or placebo. Plasma levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), glutathione peroxidase (GPx), and serum C-reactive protein (CRP) were measured at baseline and 8 weeks. Baseline data demonstrated elevated inflammation and low antioxidant levels. A significant time effect (p=0.03) and time x compliance interaction effect (p=0.04) were observed for IL-6. No significant differences were observed for any other variables. This study demonstrates that mild and moderate CKD is associated with chronic inflammation and low antioxidant activity. Systemic inflammation and impaired antioxidant status may be greater in CKD populations with multiple comorbidities. Curcumin and Boswellia serrata are safe and tolerable and helped to improve the levels of an inflammatory cytokine.

Keywords: chronic kidney disease,; curcumin,; Boswellia serrata,; alternative medicine

References

  • 1.

    Centers for Disease Control and Prevention. National chronic kidney disease fact sheet: general information and national estimates on chronic kidney disease in the united states, 2010. Atlanta: Department of Health and Human Services, Centers for Disease Control and Prevention, 2010.

  • 2.

    Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003;289(1):76–9.

  • 3.

    Weiner DE. Causes and consequences of chronic kidney disease: implications for managed health care. JMCP 2007;13(3 Suppl):S1–S9.

  • 4.

    Dervisoglu E, Kir HM, Kalender B, Caglayan C, Eraldemir C. Serum fetuin–a concentrations are inversely related to cytokine concentrations in patients with chronic renal failure. Cytokine 2008;44(3):323–327. doi:10.1016/j.cyto.2008.08.014 [Crossref]

  • 5.

    Oner-Iyidogan Y, Oner P, Kocak H, Gurdol F, Bekpinar S, Unlucerci Y, et al. Dimethylarginines and inflammation markers in patients with chronic kidney disease undergoing dialysis. Clin Exp Med 2009. doi:10.1007/s10238–009–0035–3 [Crossref]

  • 6.

    Pawlak K, Mysliwiec M, Pawlak D. Oxidative stress, phosphate and creatinine levels are independently associated with vascular endothelial growth factor levels in patients with chronic renal failure. Cytokine 2008;43(1):98–101. doi:10.1016/j.cyto.2008.03.011 [Crossref]

  • 7.

    Rastmanesh MM, Bluyssen HA, Joles JA, Boer P, Willekes N, Braam B. Increased expression of SOCS3 in monocytes and SOCS1 in lymphocytes correlates with progressive loss of renal function and cardiovascular risk factors in chronic kidney disease. Eur J Pharmacol 2008;593(1–3):99–104. doi:10.1016/j.ejphar.2008.07.013 [Crossref]

  • 8.

    Ceballos-Picot I, Witko-Sarsat V, Merad-Boudia M, Nguyen AT, Thevenin M, Jaudon MC, et al. Glutathione antioxidant system as a marker of oxidative stress in chronic renal failure. Free Radic Biol Med 1996;21(6):845–53.

  • 9.

    El-Far MA, Bakr MA, Farahat SE, Abd El-Fattah EA. Glutathione peroxidase activity in patients with renal disorders. Clin Exp Nephrol 2005;9(2):127–31. doi:10.1007/s10157–005–0343–1 [Crossref] [PubMed]

  • 10.

    Moradi H, Pahl MV, Elahimehr R, Vaziri ND. Impaired antioxidant activity of high-density lipoprotein in chronic kidney disease. Trans Res 2009;153(2):77–85. doi:10.1016/j.trsl.2008.11.007 [Crossref]

  • 11.

    Zachara BA, Koterska D, Manitius J, Sadowski L, Dziedziczko A, Salak A, et al. Selenium supplementation on plasma glutathione peroxidase activity in patients with end-stage chronic renal failure. Biol Trace Elem Res 2004;97(1):15–30. doi:10.1385/BTER:97:1:15 [Crossref]

  • 12.

    Batista Junior ML, Lopes RD, Seelaender MC, Lopes AC. Anti-inflammatory effect of physical training in heart failure: role of TNF-alpha and IL-10. Arq Bras Cardiol 2009;93(6):643–51, 692–700.

  • 13.

    Mena MP, Sacanella E, Vazquez-Agell M, Morales M, Fito M, Escoda R, et al. Inhibition of circulating immune cell activation: a molecular antiinflammatory effect of the mediterranean diet. Am J Clin Nutr 2009;89(1):248–56. doi:10.3945/ajcn.2008.26094 [Crossref]

  • 14.

    Goicoechea M, de Vinuesa SG, Lahera V, Cachofeiro V, Gomez-Campdera F, Vega A, et al. Effects of atorvastatin on inflammatory and fibrinolytic parameters in patients with chronic kidney disease. J Am Soc Nephrol 2006;17(12 Suppl 3):S231–S235. doi:10.1681/ASN.2006080938 [Crossref]

  • 15.

    Stenvinkel P, Andersson P, Wang T, Lindholm B, Bergstrom J, Palmblad J, et al. Do ACE-inhibitors suppress tumour necrosis factor-alpha production in advanced chronic renal failure? J Intern Med 1999;246(5):503–7.

  • 16.

    Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, et al. Trends in alternative medicine use in the united states, 1990–1997: results of a follow-up national survey. JAMA 1998;280(18):1569–75.

  • 17.

    Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults: United states, 2002. Adv Data 2004;343(343):1–19.

  • 18.

    Hatcher H, Planalp R, Cho J, Torti FM, Torti SV. Curcumin: from ancient medicine to current clinical trials. Cell Mol Life Sci 2008;65(11):1631–1652. doi:10.1007/s00018–008–7452–4 [Crossref]

  • 19.

    Fu Y, Zheng S, Lin J, Ryerse J, Chen A. Curcumin protects the rat liver from CCl4-caused injury and fibrogenesis by attenuating oxidative stress and suppressing inflammation. Mol Pharmacol 2008;73(2):399–409. doi:10.1124/mol.107.039818 [Crossref]

  • 20.

    Kuhad A, Pilkhwal S, Sharma S, Tirkey N, Chopra K. Effect of curcumin on inflammation and oxidative stress in cisplatin-induced experimental nephrotoxicity. J Agric Food Chem 2007;55(25):10150–5. doi:10.1021/jf0723965 [Crossref]

  • 21.

    Reyes-Gordillo K, Segovia J, Shibayama M, Vergara P, Moreno MG, Muriel P. Curcumin protects against acute liver damage in the rat by inhibiting NF-kappaB, proinflammatory cytokines production and oxidative stress. Biochim Biophys Acta 2007;1770(6):989–96. doi:10.1016/j.bbagen.2007.02.004 [Crossref]

  • 22.

    Ghosh SS, Massey HD, Krieg R, Fazelbhoy ZA, Ghosh S, Sica DA, et al. Curcumin ameliorates renal failure in 5/6 nephrectomized rats: the role of inflammation. Am J Physiol Ren Physiol 2009. doi:10.1152/ajprenal.90732.2008 [Crossref]

  • 23.

    Usharani P, Mateen AA, Naidu MU, Raju YS, Chandra N. Effect of NCB-02, atorvastatin and placebo on endothelial function, oxidative stress and inflammatory markers in patients with type 2 diabetes mellitus: a randomized, parallel-group, placebo-controlled, 8-week study. Drugs RD 2008;9(4):243–50. [Crossref]

  • 24.

    Gupta I, Parihar A, Malhotra P, Singh GB, Ludtke R, Safayhi H, et al. Effects of boswellia serrata gum resin in patients with ulcerative colitis. Eur J Med Res 1997;2(1):37–43.

  • 25.

    Gupta I, Parihar A, Malhotra P, Gupta S, Ludtke R, Safayhi H, et al. Effects of gum resin of Boswellia serrata in patients with chronic colitis. Planta Med 2001;67(5):391–95.

  • 26.

    Madisch A, Miehlke S, Eichele O, Mrwa J, Bethke B, Kuhlisch E, et al. Boswellia serrata extract for the treatment of collagenous colitis. A double-blind, randomized, placebo-controlled, multicenter trial. Int J Colorectal Dis 2007;22(12):1445–51. doi:10.1007/s00384–007–0364–1 [Crossref]

  • 27.

    Sengupta K, Alluri KV, Satish AR, Mishra S, Golakoti T, Sarma KV, et al. A double blind, randomized, placebo controlled study of the efficacy and safety of 5-loxin for treatment of osteoarthritis of the knee. Arthritis Res Ther 2008;10(4):R85. doi:10.1186/ar2461

  • 28.

    Bayrak O, Uz E, Bayrak R, Turgut F, Atmaca AF, Sahin S, et al. Curcumin protects against ischemia/reperfusion injury in rat kidneys. World J Urol 2008;26(3):285–91. doi:10.1007/s00345–008–0253–4 [Crossref]

  • 29.

    Rafiee P, Nelson VM, Manley S, Wellner M, Floer M, Binion DG, et al. Effect of curcumin on acidic pH-induced expression of IL-6 and IL-8 in human esophageal epithelial cells (HET-1A): role of PKC, MAPKs, and NF-kappaB. Am J Physiol Gastrointest Liver Physiol 2009;296(2):G388–G398. doi:10.1152/ajpgi.90428.2008

  • 30.

    Jasti S, Siega-Riz AM, Cogswell ME, Hartzema AG, Bentley ME. Pill count adherence to prenatal multivitamin/mineral supplement use among low-income women. J Nutr 2005;135(5):1093–101.

  • 31.

    Lee JY, Greene PG, Douglas M, Grim C, Kirk KA, Kusek JW, et al. Appointment attendance, pill counts, and achievement of goal blood pressure in the African American study of kidney disease and hypertension pilot study. Control Clin Trials 1996;17(4 Suppl):34S-39S. [Crossref]

  • 32.

    National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002;39(2 Suppl 1):S1–S266.

  • 33.

    Chan MM. Inhibition of tumor necrosis factor by curcumin, a phytochemical. Biochem Pharmacol 1995;49(11):1551–6. [Crossref]

  • 34.

    Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee – a randomized double blind placebo controlled trial. Phytomed Int J Phytotherap Phytopharmacol 2003;10(1):3–7. [Crossref]

  • 35.

    Cuaz-Perolin C, Billiet L, Bauge E, Copin C, Scott-Algara D, Genze F, et al. Antiinflammatory and antiatherogenic effects of the NF-kappaB inhibitor acetyl-11-keto-beta-boswellic acid in LPS-challenged ApoE-/- mice. Arterioscler Thromb Vasc Biol 2008;28(2):272–277. doi:10.1161/ATVBAHA.107.155606 [Crossref]

  • 36.

    Gayathri B, Manjula N, Vinaykumar KS, Lakshmi BS, Balakrishnan A. Pure compound from Boswellia serrata extract exhibits anti-inflammatory property in human PBMCs and mouse macrophages through inhibition of TNFalpha, IL-1beta, NO and MAP kinases. Int Immunopharmacol 2007;7(4):473–82. doi:10.1016/j.intimp.2006.12.003 [Crossref]

  • 37.

    Mezzano S, Aros C, Droguett A, Burgos ME, Ardiles L, Flores C, et al. NF-kappaB activation and overexpression of regulated genes in human diabetic nephropathy. Nephrol Dial Transplant 2004;19(10):2505–12. doi:10.1093/ndt/gfh207 [Crossref]

  • 38.

    Banerjee M, Tripathi LM, Srivastava VM, Puri A, Shukla R. Modulation of inflammatory mediators by ibuprofen and curcumin treatment during chronic inflammation in rat. Immunopharmacol Immunotoxicol 2003;25(2):213–24. [Crossref]

  • 39.

    Sander O, Herborn G, Rau R. Is H15 (resin extract of Boswellia serrata, “incense”) a useful supplement to established drug therapy of chronic polyarthritis? results of a double-blind pilot study. [Ist H15 (Harzextrakt von Boswellia serrata, “Weihrauch”) eine sinnvolle Erganzung zur etablierten medikamentosen Therapie der chronischen Polyarthritis?–Ergebnisse einer doppelblinden Pilotstudie]. Z Rheumatol 1998;57(1):11–6.

  • 40.

    Heinrich PC, Castell JV, Andus T. Interleukin-6 and the acute phase response. Biochem J 1990;265(3):621–36.

  • 41.

    Yudkin JS, Kumari M, Humphries SE, Mohamed-Ali V. Inflammation, obesity, stress and coronary heart disease: Is interleukin-6 the link? Atherosclerosis 2000;148(2):209–14.

  • 42.

    Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. New Engl J Med 1997;336(14):973–9. doi:10.1056/NEJM199704033361401 [Crossref]

  • 43.

    Naesh O. Back to the future: postoperative pain management beyond COX-2 inhibitors. N Z Med J 2006;119(1242):U2170.

  • 44.

    Avissar N, Ornt DB, Yagil Y, Horowitz S, Watkins RH, Kerl EA, et al. Human kidney proximal tubules are the main source of plasma glutathione peroxidase. Am J Physiol 1994;266(2 Pt 1):C367–C375.

  • 45.

    Venkatesan N, Punithavathi D, Arumugam V. Curcumin prevents adriamycin nephrotoxicity in rats. Br J Pharmacol 2000;129(2):231–4. doi:10.1038/sj.bjp.0703067 [Crossref]

  • 46.

    Fernandez-Real JM, Broch M, Vendrell J, Richart C, Ricart W. Interleukin-6 gene polymorphism and lipid abnormalities in healthy subjects. J Clin Endocrinol Metab 2000;85(3):1334–9. [Crossref]

  • 47.

    Stenvinkel P, Ketteler M, Johnson RJ, Lindholm B, Pecoits-Filho R, et al. IL-10, IL-6, and TNF-alpha: central factors in the altered cytokine network of uremia–the good, the bad, and the ugly. Kidney Int 2005;67(4):1216–33. doi:10.1111/j.1523–1755. 2005.00200.x [Crossref]

  • 48.

    Richard MJ, Arnaud J, Jurkovitz C, Hachache T, Meftahi H, Laporte F, et al. Trace elements and lipid peroxidation abnormalities in patients with chronic renal failure. Nephron 1991;57(1):10–5. [Crossref]

  • 49.

    Hill KE, Burk RF, Lane JM. Effect of selenium depletion and repletion on plasma glutathione and glutathione-dependent enzymes in the rat. J Nutr 1987;117(1):99–104.

  • 50.

    Cohen HJ, Chovaniec ME, Mistretta D, Baker SS. Selenium repletion and glutathione peroxidase–differential effects on plasma and red blood cell enzyme activity. Am J Clin Nutr 1985;41(4):735–47.

  • 51.

    Furukawa S, Fujita T, Shimabukuro M, Iwaki M, Yamada Y, Nakajima Y, et al. Increased oxidative stress in obesity and its impact on metabolic syndrome. J Clin Invest 2004;114(12):1752–61. doi:10.1172/JCI21625 [Crossref]

  • 52.

    Robertson RP. Chronic oxidative stress as a central mechanism for glucose toxicity in pancreatic islet beta cells in diabetes. J Biol Chem 2004;279(41):42351–4. doi:10.1074/jbc.R400019200 [Crossref]

  • 53.

    Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, et al; American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on kidney in cardiovascular disease, high blood pressure research, clinical cardiology, and epidemiology and prevention. Hypertension 2003;42(5):1050–65. doi:10.1161/01.HYP.0000102971.85504.7c [Crossref]

  • 54.

    Arici M, Walls J. End-stage renal disease, atherosclerosis, and cardiovascular mortality: Is C-reactive protein the missing link? Kidney Int 2001;59(2):407–14. doi:10.1046/j.1523–1755.2001. 059002407.x [Crossref]

  • 55.

    Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. New Eng J Med 2004;351(13):1296–305. doi:10.1056/NEJMoa041031 [Crossref]

  • 56.

    Kimmel PL, Phillips TM, Simmens SJ, Peterson RA, Weihs KL, Alleyne S, et al. Immunologic function and survival in hemodialysis patients. Kidney Int 1998;54(1):236–44. doi:10.1046/j.1523–1755.1998.00981.x [Crossref]

  • 57.

    Pecoits-Filho R, Barany P, Lindholm B, Heimburger O, Stenvinkel P. Interleukin-6 is an independent predictor of mortality in patients starting dialysis treatment. Nephrol Dial Transplant 2002;17(9):1684–8.

  • 58.

    Tripepi G, Mallamaci F, Zoccali C. Inflammation markers, adhesion molecules, and all-cause and cardiovascular mortality in patients with ESRD: searching for the best risk marker by multivariate modeling. J Am Soc Nephrol 2005;16(Suppl 1):S83–S88. [Crossref]

About the article

Received: 2011-09-07

Accepted: 2012-05-17

Published Online: 2013-07-01


Citation Information: Journal of Complementary and Integrative Medicine, ISSN (Online) 1553-3840, ISSN (Print) 2194-6329, DOI: https://doi.org/10.1515/jcim-2012-0011. Export Citation

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

[1]
Angélica Saraí Jiménez-Osorio, Wylly Ramsés García-Niño, Susana González-Reyes, Alejandra Elizabeth Álvarez-Mejía, Sebastián Guerra-León, Jonathan Salazar-Segovia, Ilse Falcón, Héctor Montes de Oca-Solano, Magdalena Madero, and José Pedraza-Chaverri
Journal of Renal Nutrition, 2016
[2]
Liyu He, Xiaofei Peng, Jiefu Zhu, Guoyong Liu, Xian Chen, Chengyuan Tang, Hong Liu, Fuyou Liu, and Youming Peng
Canadian Journal of Physiology and Pharmacology, 2015, Volume 93, Number 4, Page 275

Comments (0)

Please log in or register to comment.
Log in