Condition
End-Stage Renal Disease
End-stage renal disease is when the kidneys have lost nearly all function, letting toxins, fluid, and minerals build up in the blood and making dialysis or a transplant necessary. Among supplements, L-carnitine and cordyceps have the most support, with moderate evidence: trials found blood pressure improved with L-carnitine, and blood urea nitrogen went down with cordyceps. Those studies were small, and several other supplements showed no clear difference in inflammation.
Sources: PMID 31481697
- Supplements studied
- 10
- Graded outcomes
- 8
- Trials
- 7
- People studied
- 9,125
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Urea Nitrogen (BUN) Small Decrease | Improves (the measure goes down) | Small effect | 2,914 people | |||
| C-Reactive Protein (CRP) | Improves (the measure goes down) | 1 study | 2,914 people | |||
Studies that measured c-reactive protein (crp) | ||||||
| Hemoglobin | Improves (the measure goes up) | 2,914 people | ||||
| Serum Albumin | Improves (the measure goes up) | 2,914 people | ||||
Coenzyme Q10
- Blood glucose: improves
- Low-density lipoprotein (LDL): improves
- HbA1c: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood glucose Small Improvement | Improves (the measure goes down) | Small effect | 3 studies | 60 people | ||
Studies that measured blood glucose
| ||||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 4 studies | 60 people | |||
Studies that measured low-density lipoprotein (ldl)
| ||||||
| HbA1c | Improves (the measure goes down) | 2 studies | 60 people | |||
| Total cholesterol | Improves (the measure goes down) | 2 studies | 60 people | |||
Studies that measured total cholesterol | ||||||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 1 study | 60 people | |||
Studies that measured high-density lipoprotein (hdl) | ||||||
| Glycemic Control | Improves (the measure goes up) | 60 people | ||||
| Insulin | Changes; see studies | 60 people | ||||
| Triglycerides | Improves (the measure goes down) | 60 people | ||||
| vLDL-C | Improves (the measure goes down) | 60 people | ||||
Zinc
- C-Reactive Protein (CRP): improves
- Testosterone: improves
- Luteinizing Hormone: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) Small Decrease | Improves (the measure goes down) | Small effect | 1 study | 55 people | ||
Studies that measured c-reactive protein (crp) | ||||||
| Testosterone | Improves (the measure goes up) | 3 studies | 95 people | |||
Studies that measured testosterone
| ||||||
| Luteinizing Hormone | Improves (the measure goes up) | 95 people | ||||
| Prolactin | Improves (the measure goes up) | 95 people | ||||
Alpha-Lipoic Acid
- C-Reactive Protein (CRP)
- Oxidative Stress Biomarkers: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) No effect | NoneNo effect | 2 studies | 63 people | |||
Studies that measured c-reactive protein (crp) | ||||||
| Oxidative Stress Biomarkers | Changes; see studies | 4 studies | 63 people | |||
Studies that measured oxidative stress biomarkers | ||||||
Sea Buckthorn
- C-Reactive Protein (CRP)
- DNA Damage: changes; see studies
- Inflammation: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) No effect | NoneNo effect | 45 people | ||||
| DNA Damage | Changes; see studies | 1 study | 45 people | |||
| Inflammation | Improves (the measure goes down) | 45 people | ||||
Sodium Bicarbonate
- Blood Pressure
- Serum Bicarbonate: improves
- Kidney Function: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Pressure No effect | NoneNo effect | 1,380 people | ||||
| Serum Bicarbonate | Improves (the measure goes up) | 26 studies | 1,380 people | |||
| Kidney Function | Improves (the measure goes up) | 1 study | 1,380 people | |||
| Heart Failure Risk | Changes; see studies | 1,380 people | ||||
| Leg Edema | Changes; see studies | 1,380 people | ||||
Resistant Starch
- C-Reactive Protein (CRP)
- TNF-Alpha: improves
- Interleukin 6: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) No effect | NoneNo effect | 467 people | ||||
| TNF-Alpha | Improves (the measure goes down) | 1 study | 467 people | |||
Studies that measured tnf-alpha | ||||||
| Interleukin 6 | Improves (the measure goes down) | 467 people | ||||
| Oxidative Stress Biomarkers | Improves (the measure goes down) | 467 people | ||||
| Superoxide Dismutase Activity | Improves (the measure goes up) | 467 people | ||||
| Total Antioxidant Capacity (TAC) | Improves (the measure goes up) | 467 people | ||||
Curcumin
- Oxidative Stress Biomarkers: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Oxidative Stress Biomarkers | Improves (the measure goes down) | 6 studies | 167 people | |||
Studies that measured oxidative stress biomarkers
| ||||||
Creatine
- Kidney Function: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Kidney Function | Improves (the measure goes up) | 5 studies | 45 people | |||
Studies that measured kidney function
| ||||||
Key findings
- Blood PressureImproves (the measure goes down)
- Blood Urea Nitrogen (BUN)Improves (the measure goes down)
- Blood glucoseImproves (the measure goes down)
The End-Stage Renal Disease (Chronic Kidney Disease Stage 5) protocol
2 primary supplements · 5 supporting supplements
- L-Carnitine1–2 g daily (or IV after dialysis as prescribed)
- Vitamin D (Calcitriol or Analogs)Active form as prescribed by nephrologist
Shop the evidence-backed picks
Support alongside medical care. These supplements are not a treatment for End-Stage Renal Disease. If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.
The supplements graded A or B for End-Stage Renal Disease. Each opens third-party tested products for that supplement.
- Grade B
- Grade B
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Studies cited
100 studies from PubMed
- Effects of Coenzyme Q10 Supplementation on Depressive Symptoms and Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
- Effect of curcumin on inflammatory markers and disease activity in patients with rheumatoid arthritis: A meta-analysis.
- The Effect of Antioxidant Polyphenol Supplementation on Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis.
- The Effectiveness of Curcumin, Resveratrol, and Silymarin on MASLD: A Systematic Review and Meta-Analysis.
- Does creatine supplementation improve glycemic control and insulin resistance in healthy and diabetic patients? A systematic review and meta-analysis.
- Curcumin alleviates postprandial glycaemic response in healthy subjects: A cross-over, randomized controlled study
- Substantial Variability Across Individuals in the Vascular and Nutrigenomic Response to an Acute Intake of Curcumin: A Randomized Controlled Trial
- Curcumin supplementation improves vascular endothelial function in healthy middle-aged and older adults by increasing nitric oxide bioavailability and reducing oxidative stress
- Novel Form of Curcumin Improves Endothelial Function in Young, Healthy Individuals: A Double-Blind Placebo Controlled Study
- Effect of different curcuminoid supplement dosages on total in vivo antioxidant capacity and cholesterol levels of healthy human subjects
- Effects of Curcuma longa (turmeric) on postprandial plasma glucose and insulin in healthy subjects
- Combined inhibitory effects of soy isoflavones and curcumin on the production of prostate-specific antigen
- Role of creatine supplementation on exercise-induced cardiovascular function and oxidative stress
- Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players
- Does creatine supplementation improve the plasma lipid profile in healthy male subjects undergoing aerobic training
- Effects of creatine supplementation on glucose tolerance and insulin sensitivity in sedentary healthy males undergoing aerobic training
- Effect of NCB-02, atorvastatin and placebo on endothelial function, oxidative stress and inflammatory markers in patients with type 2 diabetes mellitus: a randomized, parallel-group, placebo-controlled, 8-week study
- Chili, but not turmeric, inhibits iron absorption in young women from an iron-fortified composite meal
- Creatine supplementation increases glycogen storage but not GLUT-4 expression in human skeletal muscle
- Creatine supplementation affects glucose homeostasis but not insulin secretion in humans
- Creatine supplementation and health variables: a retrospective study
- Effect of oral creatine supplementation on human muscle GLUT4 protein content after immobilization
- Role of submaximal exercise in promoting creatine and glycogen accumulation in human skeletal muscle
- Effects of alpha-lipoic acid supplementation in peripheral arterial disease: a pilot study
- Down syndrome and dementia: a randomized, controlled trial of antioxidant supplementation
- Effects of antioxidant supplements intervention on the level of plasma inflammatory molecules and disease severity of rheumatoid arthritis patients
- Effect of α-lipoic acid and exercise training on cardiovascular disease risk in obesity with impaired glucose tolerance
- Alpha-lipoic acid supplementation: a tool for obesity therapy?
- Effects of alpha-lipoic Acid on body weight in obese subjects
- Oral antioxidant supplementation does not prevent acute mountain sickness: double blind, randomized placebo-controlled trial
- A preliminary evaluation of a novel method to monitor a triple antioxidant combination (vitamins E, C and α-lipoic acid) in diabetic volunteers using in vitro methaemoglobin formation
- Glycemic and oxidative status of patients with type 2 diabetes mellitus following oral administration of alpha-lipoic acid: a randomized double-blinded placebo-controlled study
- Complementary therapy in diabetic patients with chronic complications: a pilot study
- The effects of lipoic acid and α-tocopherol supplementation on the lipid profile and insulin sensitivity of patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial
- Alpha-lipoic acid does not acutely affect resistance and conduit artery function or oxidative stress in healthy men
- Effects of Alpha-Lipoic Acid Supplementation on Inflammation, Oxidative Stress, and Serum Lipid Profile Levels in Patients with End-Stage Renal Disease on Hemodialysis
- Alpha-lipoic acid improves endothelial dysfunction in patients with subclinical hypothyroidism
- Irbesartan and lipoic acid improve endothelial function and reduce markers of inflammation in the metabolic syndrome: results of the Irbesartan and Lipoic Acid in Endothelial Dysfunction (ISLAND) study
- Oral antioxidants and cardiovascular health in the exercise-trained and untrained elderly: a radically different outcome
- Effects of supplementation with alpha-lipoic acid on exercise-induced activation of coagulation
- Efficacy and safety of antioxidant treatment with α-lipoic acid over 4 years in diabetic polyneuropathy: the NATHAN 1 trial
- Alpha-lipoic acid improves vascular endothelial function in patients with type 2 diabetes: a placebo-controlled randomized trial
- Effect of alpha-lipoic acid combined with creatine monohydrate on human skeletal muscle creatine and phosphagen concentration
- Alpha-lipoic acid modifies oxidative stress parameters in sickle cell trait subjects and sickle cell patients
- The use of alpha-lipoic acid (ALA), gamma linolenic acid (GLA) and rehabilitation in the treatment of back pain: effect on health-related quality of life
- Assessment of the antioxidant effectiveness of alpha-lipoic acid in healthy men exposed to muscle-damaging exercise
- Restoration of blood total glutathione status and lymphocyte function following alpha-lipoic acid supplementation in patients with HIV infection
- Efficacy of Alpha Lipoic Acid Supplementation in Sperm Parameters: A Systematic Review and Meta-Analysis of Randomized Trials.
- L-carnitine ameliorated fasting-induced fatigue, hunger, and metabolic abnormalities in patients with metabolic syndrome: a randomized controlled study
- L-Carnitine's Effect on the Biomarkers of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Ameliorating hypertension and insulin resistance in subjects at increased cardiovascular risk: effects of acetyl-L-carnitine therapy
- Comparative study to evaluate the effect of l-carnitine plus glimepiride versus glimepiride alone on insulin resistance in type 2 diabetic patients
- Effects of simvastatin and carnitine versus simvastatin on lipoprotein(a) and apoprotein(a) in type 2 diabetes mellitus
- Comparison between orlistat plus l-carnitine and orlistat alone on inflammation parameters in obese diabetic patients
- Effects of combination of sibutramine and L-carnitine compared with sibutramine monotherapy on inflammatory parameters in diabetic patients
- L-Carnitine supplementation reduces oxidized LDL cholesterol in patients with diabetes
- Effect of L-carnitine on plasma glycemic and lipidemic profile in patients with type II diabetes mellitus
- Effect of carnitine-orotate complex on glucose metabolism and fatty liver: a double-blind, placebo-controlled study
- Efficacy and tolerability of combined treatment with L-carnitine and simvastatin in lowering lipoprotein(a) serum levels in patients with type 2 diabetes mellitus
- Blood Pressure and Metabolic Effects of Acetyl-l-Carnitine in Type 2 Diabetes: DIABASI Randomized Controlled Trial
- The effects of oral L-carnitine treatment on blood lipid metabolism and the body fat content in the diabetic patient
- The effect of L-carnitine on plasma lipoprotein(a) levels in hypercholesterolemic patients with type 2 diabetes mellitus
- The effects of L-carnitine supplementation on cardiovascular risk factors in participants with impaired glucose tolerance and diabetes: a systematic review and dose-response meta-analysis.
- Effects of acetyl-L-carnitine and methylcobalamin for diabetic peripheral neuropathy: A multicenter, randomized, double-blind, controlled trial
- Effect of oral L-carnitine administration on insulin sensitivity and lipid profile in type 2 diabetes mellitus patients
- The effects of L-carnitine supplementation on glycemic markers in adults: A systematic review and dose-response meta-analysis.
- L-carnitine improves glucose disposal in type 2 diabetic patients
- Caloric restriction and L-carnitine administration improves insulin sensitivity in patients with impaired glucose metabolism
- Preliminary observations on the use of propionyl-L-carnitine in combination with sildenafil in patients with erectile dysfunction and diabetes
- Acetyl-l-carnitine versus placebo for migraine prophylaxis: A randomized, triple-blind, crossover study
- The effects of magnesium, L-carnitine, and concurrent magnesium-L-carnitine supplementation in migraine prophylaxis
- Effects of carnitine on glucose and lipid metabolic profiles and fertility outcomes in women with polycystic ovary syndrome: A systematic review and meta-analysis.
- Oral carnitine supplementation reduces body weight and insulin resistance in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial
- Effects of Carnitine Administration on Carotid Intima-media Thickness and Inflammatory Factors in Patients with Polycystic Ovary Syndrome: A Randomized, Double-blind, Placebo-controlled Trial
- Effects of L-carnitine supplementation for women with polycystic ovary syndrome: a systematic review and meta-analysis
- Effect of glycine propionyl-L-carnitine on aerobic and anaerobic exercise performance
- Influence of L-carnitine administration on maximal physical exercise
- Effects of nine weeks L-Carnitine supplementation on exercise performance, anaerobic power, and exercise-induced oxidative stress in resistance-trained males
- l-Carnitine l-tartrate supplementation favorably affects biochemical markers of recovery from physical exertion in middle-aged men and women
- Glycine propionyl-L-carnitine produces enhanced anaerobic work capacity with reduced lactate accumulation in resistance trained males
- Chronic oral ingestion of L-carnitine and carbohydrate increases muscle carnitine content and alters muscle fuel metabolism during exercise in humans
- The effect of oral supplementation with L-carnitine on maximum and submaximum exercise capacity
- Effect of intravenous L-carnitine on carnitine homeostasis and fuel metabolism during exercise in humans
- Effects of prolonged L-carnitine administration on delayed muscle pain and CK release after eccentric effort
- l-Carnitine Supplementation in Older Women. A Pilot Study on Aging Skeletal Muscle Mass and Function
- Effects of L-carnitine L-tartrate supplementation on muscle oxygenation responses to resistance exercise
- The effects of L-carnitine L-tartrate supplementation on hormonal responses to resistance exercise and recovery
- Levocarnitine administration in elderly subjects with rapid muscle fatigue: effect on body composition, lipid profile and fatigue
- Oxidative stress in response to aerobic and anaerobic power testing: influence of exercise training and carnitine supplementation
- Effect of L-carnitine on submaximal exercise metabolism after depletion of muscle glycogen
- Androgenic responses to resistance exercise: effects of feeding and L-carnitine
- Carbohydrate, protein, and fat metabolism during exercise after oral carnitine supplementation in humans
- Effects of four weeks L-carnitine L-tartrate ingestion on substrate utilization during prolonged exercise
- L -Carnitine and the recovery from exhaustive endurance exercise: a randomised, double-blind, placebo-controlled trial
- Effects of carnitine coingested caffeine on carnitine metabolism and endurance capacity in athletes
- Effects of L-carnitine supplementation on physical performance and energy metabolism of endurance-trained athletes: a double-blind crossover field study
- Clinical Effects of L-Carnitine Supplementation on Physical Performance in Healthy Subjects, the Key to Success in Rehabilitation: A Systematic Review and Meta-Analysis from the Rehabilitation Point of View.
- L-Carnitine/Simvastatin Reduces Lipoprotein (a) Levels Compared with Simvastatin Monotherapy: A Randomized Double-Blind Placebo-Controlled Study
- Effect of lysine, vitamin B(6), and carnitine supplementation on the lipid profile of male patients with hypertriglyceridemia: a 12-week, open-label, randomized, placebo-controlled trial
- L-carnitine infusion does not alleviate lipid-induced insulin resistance and metabolic inflexibility