New research from the University of Pennsylvania finds nicotinamide adenine dinucleotide (NAD) as a possible treatment or preventative measure for kidney disease.
Penn researchers reveal the kidney function of mice improves with supplements such as nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN), which raise NAD levels in their study published in the journal Nature Metabolism.
According to the CDC, kidney diseases are the leading cause of death in the United States. The CDC says every 24 hours, 360 Americas commence dialysis treatment for kidney Failure. An estimated 37 million Americans have chronic kidney disease, which is the gradual loss of kidney function. Kidneys serve as filters for waste and excess fluid from the blood that are released in urine. Advanced chronic kidney disease can also result in a higher likelihood of obtaining anemia.
Risk factors associated with chronic kidney disease include diabetes, high blood pressure, heart disease, smoking, obesity, and a family history of the disease.
Mice study findings
NAD is one of the most abundant molecules in the body and is essential for converting food into energy. It plays a vital role in the mitochondria — the powerhouses of the cell. As we age, NAD levels begin to decrease. In recent years, NMN and NR have become popular anti-aging supplements. Decreased NAD levels can lead to cases of depression, cognitive decline, cancer, metabolic disease, sarcopenia, and frailty.
NMN is a dietary supplement that is a precursor to NAD+ and NADH which are vital for mitochondrial function. NR is another form of vitamin B3 and a dietary supplement. NR is also able to raise NAD levels.
By using unbiased metabolic studies, Penn researchers identified changes in NAD levels in both mice and humans. In the mice study, investigators revealed the benefits of NMN and NR versus kidney disease.
Kidney tub cells help provide nutrients to the body’s bloodstream. When the mitochondria in those cells are damaged, NAD supplements successfully contain the damage, therefore protecting mice from kidney disease. Researchers did not see a difference in the effectiveness between NR and NMN.
Co-lead investigator and professor of Nephrology at Penn Medicine, Katalin Susztak, M.D., Ph.d., says the research may be a springboard to kidney disease treatments.
"We hope that this research can lead to improved care in the future," Susztak says.
One of the supplements mentioned in the study, NMN, is currently no longer available for sale on Amazon. The online retailer announced it would require further documentation from all NMN suppliers if they wanted to continue selling their product on the site.
The Amazon decision comes in light of the FDA decision in October 2022, to remove NMN’s dietary supplement status. NMM is currently under investigation as a new drug by Metro International Biotech.
Preventive steps for kidney disease
The CDC recommends keeping blood pressure below 140/90 mm Hg or the number discussed with a doctor. For those with diabetes, the CDC encourages remaining in the recommended targeted blood sugar range.
Smoking can worsen the effects of kidney disease and interrupt medication that lowers blood pressure. Over 16 million Americans die from a smoking-related disease each year, with chronic kidney disease being one of the culprits.
Losing weight can also lower the risk of chronic kidney disease. According to the CDC, obesity prevalence in the U.S. between 2017 and 2020 was 41.9%. Physical activity is recommended as a way to combat obesity, but can also help control blood pressure and blood sugar levels.
At the minimum, the U.S. Surgeon General recommends for adults 150 minutes of exercise per week and 60 minutes of play per day for children.
When eating, removing comfort food and sugar-sweetened beverages will help against added calories with little nutritional benefit. Nutritious meals should consist of healthy servings of fruits and vegetables and lean meats as opposed to processed meats.
At the moment, there is no cure for chronic kidney disease. However, these are healthy lifestyle changes that everyone can implement.