Narrative Review on Dietary Modulation of Inflammation in Nephrotic Syndrome and Chronic Kidney Disease
DOI:
https://doi.org/10.47941/ijhs.3695Keywords:
Nephrotic Syndrome, Chronic Kidney Disease, Inflammation, Oxidative Stress, Gut Dysbiosis, Omega-3 PUFAs, Mediterranean DietAbstract
Purpose: The purpose of this study is to investigate the role of chronic inflammation in the progression of nephrotic syndrome (NS) and chronic kidney disease (CKD), with a focus on mechanisms including glomerular injury, proteinuria-induced tubular NF-κB activation, oxidative stress, uremic toxin accumulation, gut dysbiosis, and their contribution to cardiovascular complications and progression to end-stage renal disease (ESRD).
Methodology: Literature searches from inception to December 20, 2025, were performed on PubMed, google scholar, and the Since Direct using key words such as chronic kidney disease, inflammatory markers, nephrotic syndrome were related terms. All relevant studies in the review focusing on proinflammatory, inflammatory biomarkers included if sufficient data were available.
Findings: Anti-inflammatory dietary strategies in CKD and NS patients show potential to lower proinflammatory marker levels. Larger, multicenter randomized controlled trials (RCTs) are needed to establish efficacy, safety, and quality-of-life benefits.
Unique Contribution to Theory, Policy and Practice: This review uniquely contributes by integrating dietary modulation into the inflammation-driven pathophysiology of CKD and NS, offering a mechanistic, clinically relevant, and policy-informing framework for nutrition-based interventions.
Downloads
References
1. Losappio V, Infante B, Leo S, et al. Nutrition-based management of inflammaging in CKD and renal replacement therapies. Nutrients. 2021;13(1):267.
2. Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl (2011). 2022;12:7–11.
3. Jankowski J, Floege J, Fliser D, Böhm M, Marx N. Cardiovascular disease in CKD: pathophysiological insights. Circulation. 2021;143:1157–1172.
4. Xu G, Luo K, Liu H, et al. Inflammation and oxidative stress in CKD. Ren Fail. 2015;37:45–49.
5. Calder PC. Omega-3 fatty acids and inflammatory processes. Biochem Soc Trans. 2017;45:1105–1115.
6. Wall R, Ross RP, Fitzgerald GF, Stanton C. Anti-inflammatory potential of omega-3 fatty acids. Nutr Rev. 2010;68:280–289.
7. Hu J, Liu Z, Zhang H. Omega-3 supplementation in CKD: meta-analysis. Clinics. 2017;72:58–64.
8. Deger SM, Hung AM, Ellis CD, et al. Omega-3 fatty acids in hemodialysis patients. CJASN. 2016;11:1227–1235.
9. Ranganathan N, Anteyi E. Fiber and gut microbiome in CKD. Toxins. 2022;14:183.
10. Yang HL, Feng P, Xu Y, et al. Fiber and uremic toxins: meta-analysis. J Ren Nutr. 2021;31:438–447.
11. Camerotto C, Cupisti A, et al. Dietary fiber in renal diets. Nutrients. 2019;11:2149.
12. Chen L, Shi J, Ma X, et al. Microbiota-targeted therapy in CKD. Adv Nutr. 2022;13:1267–1278.
13. Ruiz-Leon AM, Camafort M, et al. Mediterranean diet immunomodulation. Cardiovasc Res. 2025;121:847–850.
14. Świątek Ł, Jeske J, et al. Vegetarian diet and CKD progression. BMC Nephrol. 2023;24:168.
15. D’Alessandro C, Cupisti A, et al. MedRen diet in CKD. Nutrients. 2023;15:1256.
16. Juraschek SP, Miller ER, Weaver CM, et al. DASH diet and CKD risk. J Am Coll Cardiol. 2017;70:2841–2851.
17. Hébert JR, Shivappa N, et al. Dietary Inflammatory Index. Adv Nutr. 2019;10:185–195.
18. Chen Q, Ou L. DII and CKD risk: meta-analysis. Eur J Clin Nutr. 2025;79:7–14.
19. Mazidi M, Shivappa N, et al. DII and CKD prevalence. Br J Nutr. 2018;120:204–209.
20. Lu X, Zhou S, Liu S, et al. DII in hypertensive CKD. Ren Fail. 2024;46:2373279.
21. Dewan SM, Meem SS, et al. Dietary salt and vascular inflammation. Clin Pathol. 2024;17:2632010X241228039.
22. Wenzel UO, Bode M, Kurts C, et al. Salt, IL-17, and hypertension. Br J Pharmacol. 2019;176:1853–1863.
23. Rodelo-Haad C, Rodríguez-Ortiz ME, et al. Phosphate toxicity in CKD. Clin Kidney J. 2025;18:i46–i60.
24. Steenbeke M, Speeckaert R, et al. AGEs and kidney disease. Int J Mol Sci. 2022;23:3439.
25. Chen S, Chen J, Li S, et al. High-fat diet and tubular injury. Front Physiol. 2021;12:786599.
26. Stenvinkel P, Meyer CJ, Block GA, et al. Western diet and inflammaging in CKD. Nephrol Dial Transplant. 2020;35:2036–2045.
27. Villani V, Frank CN, Cravedi P, et al. Fasting-mimicking diet and kidney repair. Sci Transl Med. 2024;16:eadl5514.
28. Mohammadzadeh M, Amirpour M, et al. FMD and cardiovascular risk. Diabetol Metab Syndr. 2025;17:1–10.
29. Lin X, Liang W, et al. Uremic toxins in ESRD. J Ren Nutr. 2022;32:578–586.
30. Feng Z, Wang T, Dong S, et al. Gut dysbiosis in CKD. J Int Med Res. 2021;49:3000605211053276.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Safia S. Elramli, Dr. Naser H. Ibrahim
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
