Nutraceuticals as Alternative Approach against Cadmium-Induced Kidney Damage: A Narrative Review

Cadmium (Cd) represents a public health risk due to its non-biodegradability and long biological half-life. The main target of Cd is the kidney, where it accumulates. In the present narrative review, we assessed experimental and clinical data dealing with the mechanisms of kidney morphological and functional damage caused by Cd and the state of the art about possible therapeutic managements. Intriguingly, skeleton fragility related to Cd exposure has been demonstrated to be induced both by a direct Cd toxic effect on bone mineralization and by renal failure. Our team and other research groups studied the possible pathophysiological molecular pathways induced by Cd, such as lipid peroxidation, inflammation, programmed cell death, and hormonal kidney discrepancy, that, through further molecular crosstalk, trigger serious glomerular and tubular injury, leading to chronic kidney disease (CKD). Moreover, CKD is associated with the presence of dysbiosis, and the results of recent studies have confirmed the altered composition and functions of the gut microbial communities in CKD. Therefore, as recent knowledge demonstrates a strong connection between diet, food components, and CKD management, and also taking into account that gut microbiota are very sensitive to these biological factors and environmental pollutants, nutraceuticals, mainly present in foods typical of the Mediterranean diet, can be considered a safe therapeutic strategy in Cd-induced kidney damage and, accordingly, could help in the prevention and treatment of CKD.

Automated summary

Cadmium (Cd) poses a risk to public health due to its non-biodegradability and long half-life in the body. Cd mainly targets the kidneys and accumulates there. Studies have shown that Cd exposure can lead to bone fragility, not only through direct toxic effects on bone mineralization but also due to renal failure. Further research has revealed the molecular pathways through which Cd induces serious kidney damage, including lipid peroxidation, inflammation, programmed cell death, and hormonal imbalances. Chronic kidney disease (CKD) is associated with dysbiosis, and recent studies have highlighted the altered composition and functions of gut microbiota in CKD. Considering the strong connection between diet and CKD management, nutraceuticals found in Mediterranean diet can be a safe therapeutic strategy for Cd-induced kidney damage and contribute to the prevention and treatment of CKD.