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2018 ; 9
(ä): 394
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Flavonoids in Kidney Health and Disease
#MMPMID29740333
Vargas F
; Romecín P
; García-Guillén AI
; Wangesteen R
; Vargas-Tendero P
; Paredes MD
; Atucha NM
; García-Estañ J
Front Physiol
2018[]; 9
(ä): 394
PMID29740333
show ga
This review summarizes the latest advances in knowledge on the effects of
flavonoids on renal function in health and disease. Flavonoids have
antihypertensive, antidiabetic, and antiinflammatory effects, among other
therapeutic activities. Many of them also exert renoprotective actions that may
be of interest in diseases such as glomerulonephritis, diabetic nephropathy, and
chemically-induced kidney insufficiency. They affect several renal factors that
promote diuresis and natriuresis, which may contribute to their well-known
antihypertensive effect. Flavonoids prevent or attenuate the renal injury
associated with arterial hypertension, both by decreasing blood pressure and by
acting directly on the renal parenchyma. These outcomes derive from their
interference with multiple signaling pathways known to produce renal injury and
are independent of their blood pressure-lowering effects. Oral administration of
flavonoids prevents or ameliorates adverse effects on the kidney of elevated
fructose consumption, high fat diet, and types I and 2 diabetes. These compounds
attenuate the hyperglycemia-disrupted renal endothelial barrier function, urinary
microalbumin excretion, and glomerular hyperfiltration that results from a
reduction of podocyte injury, a determinant factor for albuminuria in diabetic
nephropathy. Several flavonoids have shown renal protective effects against many
nephrotoxic agents that frequently cause acute kidney injury (AKI) or chronic
kidney disease (CKD), such as LPS, gentamycin, alcohol, nicotine, lead or
cadmium. Flavonoids also improve cisplatin- or methotrexate-induced renal damage,
demonstrating important actions in chemotherapy, anticancer and renoprotective
effects. A beneficial prophylactic effect of flavonoids has been also observed
against AKI induced by surgical procedures such as ischemia/reperfusion (I/R) or
cardiopulmonary bypass. In several murine models of CKD, impaired kidney function
was significantly improved by the administration of flavonoids from different
sources, alone or in combination with stem cells. In humans, cocoa flavanols were
found to have vasculoprotective effects in patients on hemodialysis. Moreover,
flavonoids develop antitumor activity against renal carcinoma cells with no toxic
effects on normal cells, suggesting a potential therapeutic role in patients with
renal carcinoma.