The Science of Cannabinoids and Kidney Diseases

We usually don’t think too much about our kidneys, despite the hard job they do for us, cleaning our blood by removing toxins and waste materials. But what happens if things go awry? Toxic-metabolic problems, as well as high blood pressure, genetic issues, injuries, and some medicines, are the main factors that can lead to kidney diseases and prevent these organs from functioning correctly. Common kidney problems are chronic kidney disease or acute kidney injury, but also infections, cysts, stones, and cancer. When kidneys fail completely, a dialysis or a kidney transplant are required. In the United States, kidney diseases are the ninth cause of death, which certainly puts them in the spotlight and makes the kidneys and their functioning subjects to various studies.

Research has sought to determine if cannabis and its constituents demonstrate potential as an alternative to anti-inflammatory drugs and opioids prescribed to relieve pain in chronic kidney disease.. A better understanding of the impact of cannabinoids on the renal system may lead to the development of new drugs that could treat the related symptoms of kidney diseases with fewer side effects compared to drugs available today. By law, any new medication should be at least equal in efficacy to previous ones, and mandatorily with fewer side effects with respect to the previously approved medications.

KIDNEYS AND THE URINARY SYSTEM

The main components of the urinary system are kidneys, ureters, bladder, and the urethra. This system eliminates waste from the body, contributes to regulating blood volume and blood pressure, controls electrolytes and metabolites, and regulates blood pH. Kidneys have intense blood circulation. They are mainly composed of tiny structures called nephrons, which filter our blood completely 60 times each day. Urine is formed as a result of this filtration and is passed to the bladder for temporary storage. Only a small percentage of filtered blood becomes urine, while the purified water is returned to the blood flow, together with other useful substances. Kidneys constantly clean our blood of toxins, and they also maintain a healthy balance of water and minerals, such as sodium, calcium, phosphorus, and potassium. Finally, they produce hormones which control blood pressure, develop red blood cells and play a role in vitamin D absorption.

Most kidney diseases attack the nephrons. Acute kidney injury (AKI) is a sudden loss of kidney function that is observed over a course of hours to a few days. This disease leads to complications like acidosis, excess of potassium, uremia, and may have dangerous effects on other organs. Mortality after a severe kidney injury remains high.

In chronic kidney disease (CKD) the damage usually happens slowly, over a long period of time, without making the patient feel sick until the condition becomes serious. The most common causes include diabetes and high blood pressure, while the most common complications include liquid retention, heart, neurological, and, bone diseases, and anaemia. Common symptoms are leg swelling, vomiting, loss of appetite and energy, and even mental confusion.

THE ENDOCANNABINOID SYSTEM AND KIDNEYS

Cannabinoid receptors CB1 and CB2 are found in various tissues and organs, including the kidneys. The endocannabinoid system regulates cell signalling targets that are crucial for homeostasis. Studies suggest that cannabinoids could have both beneficial and undesirable effects on the kidneys, depending on the type of renal disease, dosage, and other factors. Research has yet to fully explain how the endocannabinoid system might be involved in the development of renal conditions, or in the recovery process. However, an unbalanced endocannabinoid system—presumably an overexpression of CB1 and inhibition of CB2 receptors—could play a role in chronic kidney disease. This kind of imbalance could also be related to those occurring in obesity and type II diabetes.

VARIABLE RESEARCH RESULTS

A study published in The American Journal of Medicine collected data from 14.000 adults who took part in the US National Health and Nutrition Examination Survey. Researchers observed levels of albumin in urine, which is an indirect marker for kidney function, and found no association between past or current marijuana use and worsened kidney function or disease. Yet research at the Icahn School of Medicine at Mount Sinai in New York found chronic kidney disease (CKD) patients who used cannabis to experience a faster decline in kidney functions compared to non-users. However, this result could potentially be more related to smoke inhalation than to the direct effects of THC or other cannabinoids.

SEARCHING FOR THERAPEUTIC ALTERNATIVES

Patients with advanced chronic kidney disease experience various symptoms, such as nausea, anorexia, chronic pain, insomnia. Chronic kidney disease patients are not exempt from the adverse effects of prescribed opioids, which could increase the severity of symptoms in some cases. The limited treatment options actually increase the demand for therapeutic alternatives, but many patients choose not to wait for the development of an approved cannabis therapy and start experimenting with medical cannabis for symptom management^[1]. Nevertheless, even if medical cannabis has been used in many therapeutic applications, the evidence of its efficacy with chronic kidney disease has not been well reviewed, and not enough literature has been accumulated in order to advise properly on assumption forms and dosage.

WHERE DOES CBD FIT IN?

Can you expect to see CBD play a role in future kidney disease treatment? It’s far too early to say, but researchers are exploring the potential of CBD in managing^[2] the overall symptom burden of the condition, which includes pain, inflammation, nausea, and an overall lack of well-being.

But scientists aren’t limiting their investigation of CBD to kidney disease alone. Studies are also determining the cannabinoid’s validity in offsetting^[3] the oxidative stress and inflammation inflicted on the kidneys by chemotherapy. As research continues, the data will hopefully unveil the potential of cannabinoids in instances of kidney disease, and the safest intake methods.

EXPERIMENTING WITH CAUTION

Cannabis could have some side effects on our organs. Despite little evidence to suggest that natural cannabinoid overdose damages our kidneys, patients with kidney diseases should be particularly careful in starting alternative therapeutic regimes. In any case, discussing cannabis use with an informed healthcare specialist prior to consuming cannabis or its derivates is always a good course of action.

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