Elsevier

Nutrition

Volume 23, Issues 7–8, July–August 2007, Pages 598-602
Nutrition

Review article
Wine consumption and renal diseases: new perspectives

https://doi.org/10.1016/j.nut.2007.04.012Get rights and content

Abstract

Investigations into the relation between wine consumption and kidney disease have been limited. Patients with chronic renal failure show accelerated atherosclerotic damage and, considering the well-known protective effect of wine on the cardiovascular system, moderate wine consumption might be advantageous. Oxidative stress and endothelial dysfunction, which are inter-related, play a role in the pathophysiology of many renal diseases, including acute and chronic renal failure. Ethanol and non-alcoholic wine components, especially polyphenols, influence oxidative balance and endothelial function. Although long-term alcohol abuse has been associated with many renal alterations in humans, in experimental studies wine polyphenols enhanced kidney antioxidant defenses, exerted protective effects against renal ischemia/reperfusion injury, and inhibited apoptosis of mesangial cells. Moreover, in diabetic patients the administration of moderate amounts of red wine and a polyphenol-enriched diet slowed the progression of diabetic nephropathy. Moreover, the unfavorable effect of ethanol on blood pressure control seems to be counterbalanced by polyphenol protective effects. There is convincing evidence of a beneficial effect of controlled wine consumption patients with renal disease, but controlled clinical trials are needed to confirm this hypothesis.

Introduction

The protective effects of wine on the cardiovascular system have been widely documented. Less investigated is the relation that links wine consumption to kidney diseases. Patients with chronic renal failure (CRF) exhibit accelerated atherosclerotic damage and frequently undergo cardiovascular events [1]. It would be useful to know in detail the effects of wine components on kidney function, with the aim of clarifying whether moderate wine consumption could be allowed or even recommended in patients with renal disease.

Section snippets

Pathophysiologic mechanisms of renal disease progression

Oxidative stress and endothelial dysfunction, which are inter-related, play a role in many diseases, including atherosclerosis and several nephropathies.

Oxidative stress, defined as an imbalance between production of reactive oxygen species (ROSs) and antioxidant pathways, is involved in the pathophysiology of many renal diseases, including acute renal failure and CRF [2]. ROSs induce glomerular and tubulointerstitial damage by activating and maintaining vicious cycles through cytokine release,

Alcohol effects on kidney

In the rat kidney, acute ethanol administration causes a dose-dependent impairment of the antioxidant system [17], but long-term consumption increases the activity of antioxidant enzymes such as catalase [18], superoxide dismutase [19], and glutathione peroxidase [20], so that the prevailing long-term effect is difficult to predict, even in this animal organ.

To test the hypothesis that ethanol can inhibit tissue fibrosis and therefore progression of renal diseases, some investigators used a rat

Wine polyphenols and kidney

Recent studies [25], [26], [27] have confirmed that, among alcoholic beverages, especially wine shows healthy properties. A likely explanation can be its peculiar composition due to the methods employed to obtain it. Maturation in oak barrels distinguishes wine from beer by enriching the polyphenol content in wine. In a meta-analysis of 26 clinical studies concerning the relation between wine or beer consumption and vascular risk, Di Castelnuovo et al. [25] showed a significant inverse

Effects of ethanol and wine on arterial hypertension in CRF

The effects of wine on renal and cardiovascular diseases could be mediated also by its action on blood pressure. Moreover, from this point of view ethanol actions must be distinguished from those ascribable to polyphenols.

A recent meta-analysis [54] has underlined that ethanol consumption is directly related to the relative risk of arterial hypertension. However, hypertensive subjects who are moderate wine drinkers seem to have a lower hypertension-related mortality compared with hypertensive

Conclusions

All the studies presented in this review indicate that moderate wine consumption may be useful in patients with renal disease for its protective effect on the kidney itself and the cardiovascular system. Controlled clinical trials are needed to confirm the efficacy and minimize the risk of unfavorable effects, even though they are not easy to realize because of the subject matter.

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