Polyphenols and Novel Insights Into Post-kidney Transplant Complications and Cardiovascular Disease: A Narrative Review.

Nicolas I Bustos,Robert A Pol,Camilo G Sotomayor,Stephan J L Bakker,Gerjan J Navis

doi:10.3389/fcvm.2021.751036

Abstract

Kidney transplantation is the preferred treatment for end-stage kidney disease. It is, however, not devoid of complications. Delayed graft function related to ischemia-reperfusion injury (IRI), calcineurin inhibitor (CNI) nephrotoxicity, diabetes, and a particularly high-rate cardiovascular disease (CVD) risk, represent important complications following kidney transplantation. Oxidative stress and chronic low-grade inflammation are mechanisms of disease incompletely abrogated in stable kidney transplant recipient (KTR), contributing to the occurrence of these complications. Polyphenols, bioactive compounds with recognized antioxidant and anti-inflammatory properties have been strongly associated with prevention of CVD in the general population and have been shown to decrease IRI and antagonize CNI nephrotoxicity in animal experimental models, therefore they may have a role in prevention of complications in KTR. This narrative review aims to summarize and discuss current evidence on different polyphenols for prevention of complications, particularly prevention of CVD in KTR, pointing toward the need of further studies with potential clinical impact.

Highlights

Polyphenols are one of the numerous groups of metabolites distributed in the plant kingdom, mainly in fruits, vegetables, and red wine [1]
Most data concerning the role of polyphenols in kidney transplantation come from in vitro and in vivo animal studies aimed to test a potential role of polyphenols on inhibiting ischemia-reperfusion injury (IRI), preventing short-term complications after inducing renal ischemia by clamping the artery, followed by resumption of blood flow to simulate warm ischemia, or during hypothermia storage to simulate cold ischemia
Taking in consideration the lack of evidence concerning the direct effect of dietary polyphenols in stable kidney transplant recipients (KTR), we considered studies accounting for the effect of the polyphenols-rich Mediterranean diet (MD), as it has been investigated in human kidney transplantation

Summary

Introduction

Polyphenols are one of the numerous groups of metabolites distributed in the plant kingdom, mainly in fruits, vegetables, and red wine [1]. Most data concerning the role of polyphenols in kidney transplantation come from in vitro and in vivo animal studies aimed to test a potential role of polyphenols on inhibiting IRI, preventing short-term complications after inducing renal ischemia by clamping the artery, followed by resumption of blood flow to simulate warm ischemia, or during hypothermia storage to simulate cold ischemia.

Results

Conclusion