Glabridin: A Natural Boost for Kidney Function During Dialysis?
"Can this licorice root extract help maintain residual kidney function and improve outcomes for dialysis patients?"
For individuals undergoing long-term peritoneal dialysis (PD), changes in the peritoneal membrane can lead to complications. These changes often result from the constant contact with bio-incompatible components in dialysis solutions, leading to ultrafiltration (UF) capacity decline, fibrosis, and extracellular matrix accumulation.
Researchers have been exploring potential solutions to mitigate these effects. One area of interest is the renin-angiotensin-aldosterone system (RAAS) and its association with transforming growth factor ">(TGF-β), which plays a role in tissue repair. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are commonly used to prevent peritoneal membrane damage.
Glabridin, a compound isolated from licorice root, has demonstrated various pharmacological activities, including cytotoxic, antimicrobial, and anti-inflammatory effects. This study investigates the potential protective effects of glabridin on peritoneal function and residual renal function (RRF) in PD patients, offering a natural approach to kidney support.
The U.S. Kidney Disease Burden
Kidney disease statistics from the NIDDK cover chronic kidney disease (CKD) and end-stage kidney disease (ESKD) in the United States. The American Kidney Fund reports that about 131,000 Americans were newly diagnosed with kidney failure in 2023, the most recent data available. It also reports that 9 out of 10 people with kidney disease are unaware they have it, while about 40% of people with severely reduced kidney function who are not yet on dialysis are unaware of their disease.
Dialysis and Residual Kidney Function
The KDOQI hemodialysis guidance describes measuring dialysis by its removal of small dialyzable solutes, treating this function as central to dialysis's life-prolonging effect. A study of incremental versus standard hemodialysis evaluated whether incremental treatment could preserve residual kidney function, while noting that evidence about its safety and benefits remains limited. Separately, a study of 25 peritoneal dialysis patients aged 24 to 58 years, each with a glomerular filtration rate above 2 mL/min/1.73 m2, investigated glabridin therapy in relation to peritoneal function and residual renal function.
Glabridin's Impact on Dialysis Patients: Study Findings
A study published in the Tropical Journal of Pharmaceutical Research explored the effects of glabridin on kidney function in dialysis patients. The study involved twenty-five participants (age range, 24 - 58 years) with a glomerular filtration rate of above 2 mL/min/1.73 m2, all undergoing PD. For six months, patients received 30 mg of glabridin daily.
- Increased Dialysate CA125: Glabridin treatment led to a significant increase in mean dialysate CA125, suggesting a potential increase in mesothelial cell mass.
- Unaffected Parameters: Serum hs-CRP, VEGF, TGF-β, CTGF, daily ultrafiltration, glucose levels, Kt/V, and peritoneal transport status remained unaffected.
- Decreased Renal Function Decline: Glabridin treatment decreased the decline in peritoneal function and suppressed the elevation of profibrotic markers.
What Current Research Examines
A metabolic-profiling study examined glabridin in rat plasma, urine, bile, and feces after intragastric and intravenous administration. Its introduction describes reported pharmacological activities including anticancer, antidiabetic, antifibrosis, antiadipogenic, antioxidant, and anti-inflammatory effects. Current reviews also address dialysis adequacy, residual kidney function, hemodialysis, and the management of dialysis-dependent chronic kidney failure, including maintenance hemodialysis and peritoneal dialysis.
Why Dialysis Is Not a Complete Replacement
Dialysis removes waste and extra water from blood through mechanisms including diffusion and ultrafiltration, but it cannot completely perform all lost kidney functions. Medscape describes end-stage renal disease as complete, permanent kidney failure that can be treated only by kidney transplantation or dialysis. Sources also emphasize that dialysis, although life-sustaining, is not without complications, while chronic kidney disease is associated with substantial physical dysfunction and inactivity.
The Future of Glabridin in Kidney Care
The study indicates that glabridin shows promise in reducing the loss of peritoneal function and suppressing the elevation of profibrotic markers. These benefits suggest that glabridin can potentially improve the overall health and kidney function of individuals undergoing dialysis.
Evidence and Shared Decisions
An international expert group has developed evidence- and consensus-based guidance on implementing oral or parenteral nutritional supplementation for protein-energy wasting in patients receiving dialysis. The guidance responds to a current lack of practical direction for applying such supplementation. Research on older patients and dialysis shared decision-making examines how patients and clinicians view chronic kidney disease education and how dialysis decisions are reflected in practice.
Toward Better Dialysis Options
A Nature Reviews Nephrology perspective discusses current and projected prevalence of kidney failure requiring kidney replacement therapy and calls for changes to the ecosystem of dialysis care and technology. Stanford's January 17, 2025 report describes advances in kidney failure treatment that could offer alternatives to the challenges of regular dialysis. A Kidney360 perspective concludes that dialysis has made significant progress since its inception but that more work is needed to provide people requiring artificial kidney-function replacement with the quality of life they deserve.
Global Kidney-Care Challenges
Treatment options for kidney failure include hemodialysis, peritoneal dialysis, kidney transplantation, and nondialytic conservative kidney management. Choosing among them requires considering the individual living with kidney disease as well as local context and capacity for care delivery. Global efforts to improve kidney-disease outcomes are hindered by limited basic testing and services and by a lack of systematically collected information.
Further research is needed to fully understand the mechanisms of action and long-term effects of glabridin. Future studies could explore optimal dosages, potential interactions with other treatments, and specific benefits for different patient populations.
Glabridin represents a promising natural candidate for supporting kidney function in dialysis patients. Its potential to increase mesothelial cell mass and decrease peritoneal function decline positions it as a valuable addition to comprehensive kidney care strategies. Always consult with healthcare providers before starting any new treatment.