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Review
, 120 (10), 1149-1158

Energy Restriction in Renal Protection

Review

Energy Restriction in Renal Protection

Si-Yang Wang et al. Br J Nutr.

Abstract

Energy restriction (ER) has been widely studied as a novel intervention, and its ability to prolong life has been fully demonstrated. For example, ER can significantly extend the lifespans of model flies, worms, rodents and other mammals. The role of ER in renal protection has also been elucidated. In preclinical studies, adjusting total energy intake or consumption of specific nutrients has prophylactic or therapeutic effects on ageing-related kidney disease and acute and chronic kidney injury. Amino acid restriction has gradually attracted attention. ER mimetics have also been studied in depth. The protective mechanisms of ER and ER mimetics for renal injury include increasing AMP-activated protein kinase and sirtuin type 1 (Sirt1) levels and autophagy and reducing mammalian target of rapamycin, inflammation and oxidative stress. However, the renal protective effect of ER has mostly been investigated in rodent models, and the role of ER in patients cannot be determined due to the lack of large randomised controlled trials. To protect the kidney, the mechanism of ER must be thoroughly researched, and more accurate diet or drug interventions need to be identified.

Keywords: AKI acute kidney injury; AMPK AMP-activated protein kinase; CKD chronic kidney disease; DN diabetic nephropathy; ER energy restriction; ERM energy restriction mimetics; ESRD end-stage renal disease; HIF hypoxia-inducible factor 1; PR protein restriction; Pi inorganic phosphate; ROS reactive oxygen species; Sirt1 sirtuin type 1; TGF-β transforming growth factor-β; mTOR mammalian target of rapamycin; Ageing; Energy restriction; Inflammation; Kidney injury; Oxidative stress; Sirtuin type 1: Autophagy.

Figures

Fig. 1
Fig. 1
The mechanisms of energy restriction in renal protection. The main identified mechanisms include increased AMP-activated protein kinase (AMPK), sirtuin type 1 (Sirt1) and autophagy and reduced mammalian target of rapamycin (mTOR), inflammation and oxidative stress. SAA, sulphur amino acid; BCAA, branched-chain amino acid.

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