Condition
Diabetic Nephropathy
Can supplements help diabetic nephropathy, the kidney damage caused by diabetes? No supplement has been shown to protect the kidneys the way prescription medicines do. In large trials, losartan and canagliflozin lowered the risk of kidney failure in people with type 2 diabetes and kidney disease. Among supplements, ginkgo extract added to standard blood-pressure medicines lowered protein in the urine in a review of 41 trials, and turmeric did the same in one trial of 40 people, but that evidence is limited. Benfotiamine did not help. Damaged kidneys clear herbs and supplements more slowly, and some herbs can raise potassium, so ask your kidney doctor before taking anything.
Sources: PMID 11565518; PMID 30990260; PMID 39830333; PMID 21627399; PMID 20413516; PMID 34343992
- Supplements studied
- 4
- Graded outcomes
- 2
- Trials
- 3
- People studied
- 3,452
What the evidence says
- Prescription medicines have the strong evidence. In a trial of 1,513 people with type 2 diabetes and kidney disease, losartan cut the risk of doubled creatinine, kidney failure or death by 16% over about 3.4 years, and lowered urine protein by 35%. In a trial of 4,401 people, canagliflozin (an SGLT2 inhibitor) lowered the risk of kidney failure, doubled creatinine or death from kidney or heart causes by 30%.
- The 2022 KDIGO guideline builds care in layers: lifestyle, self-management and first-line medicines such as SGLT2 inhibitors, then other kidney- and heart-protecting drugs and control of blood pressure, blood sugar and cholesterol. Supplements are not part of it.
- Ginkgo extract has limited evidence. A 2025 review of 41 trials with 3,269 people found that adding it to an ACE inhibitor or ARB lowered urine albumin, creatinine and urine protein more than the medicine alone. It did not change HbA1c or blood pressure, and none of the trials reported whether kidney failure or heart events were prevented.
- Turmeric also has limited evidence. In a placebo-controlled trial of 40 people with type 2 diabetic kidney disease, 500 mg of turmeric with each meal for 2 months lowered urine protein. A study of curcumin (500 mg a day for 15 to 30 days) in people with type 2 diabetes also found less albumin in the urine, but it had no comparison group.
- Two options did not help the kidneys. Benfotiamine (900 mg a day for 12 weeks) did not lower urine albumin in 82 people already on an ACE inhibitor or ARB. Saffron (100 mg a day for 12 weeks) lowered systolic blood pressure in 80 people with type 2 diabetes, but creatinine, urea and urine albumin did not change.
Safety and when to see a clinician
- Kidney disease changes how the body handles medicines and supplements, so doses often need adjusting. Tell your care team about every supplement, herb and over-the-counter product you take.
- Herbal products can harm the kidneys through their own toxicity, contamination, mislabeling or interactions with medicines, and some can raise blood potassium in people with kidney damage.
- Don't stop or replace a prescribed kidney or diabetes medicine with a supplement. Ask the prescriber or pharmacist first.
- Get medical care promptly for swelling in the legs or face, much less urine than usual, shortness of breath, confusion, or blood sugar readings far above your usual range.
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Pressure Improvement | Improves (the measure goes down) | 1 study | ||||
| Creatinine No effect | 1 study | |||||
| Liver Enzymes No effect | 1 study | |||||
| Urea No effect | 1 study | |||||
| Serum Albumin | ||||||
Benfotiamine
- Kidney Function
- Proteinuria
- Blood Pressure
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Kidney Function No effect | 1 study | |||||
Studies that measured kidney function | ||||||
| Proteinuria No effect | 1 study | 63 people | ||||
Studies that measured proteinuria | ||||||
| Blood Pressure | ||||||
| HbA1c | ||||||
| High-density lipoprotein (HDL) | ||||||
| Low-density lipoprotein (LDL) | ||||||
| Triglycerides | ||||||
Ginkgo Biloba
- Anti-Oxidant Enzyme Profile
- Blood glucose
- Blood Pressure
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Anti-Oxidant Enzyme Profile | ||||||
| Blood glucose | ||||||
| Blood Pressure | ||||||
| Blood Urea Nitrogen | ||||||
| C-Reactive Protein (CRP) | ||||||
| Cystatin C | ||||||
| Fibrinogen | ||||||
| HbA1c | ||||||
| Hematocrit | ||||||
| Interleukin 6 | ||||||
| Kidney Function | ||||||
| Low-density lipoprotein (LDL) | ||||||
| Proteinuria | ||||||
| TNF-Alpha | ||||||
| Total cholesterol | ||||||
| Triglycerides | ||||||
| Urinary Albumin |
Key findings
- Blood PressureImproves (the measure goes down)
The Diabetic Nephropathy (Diabetic Kidney Disease) Supportive Care protocol
2 primary supplements · 6 supporting supplements
- Alpha-Lipoic Acid600–1,200 mg daily in divided doses
- Omega-3 Fatty Acids2–4 g EPA+DHA daily
Studies cited
11 studies from PubMed
- Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy.
- Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy.
- KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease.
- Diabetes Management in Chronic Kidney Disease: Synopsis of the KDIGO 2022 Clinical Practice Guideline Update.
- The efficacy and safety of Ginkgo biloba L. leaves extract combined with ACEI/ARB on diabetic kidney disease: a systematic review and meta-analysis of 41 randomized controlled trials.
- Oral supplementation of turmeric attenuates proteinuria, transforming growth factor-β and interleukin-8 levels in patients with overt type 2 diabetic nephropathy: a randomized, double-blind and placebo-controlled study.
- Curcumin attenuates urinary excretion of albumin in type II diabetic patients with enhancing nuclear factor erythroid-derived 2-like 2 (Nrf2) system and repressing inflammatory signaling efficacies.
- A double-blind, randomized, placebo-controlled clinical trial on benfotiamine treatment in patients with diabetic nephropathy.
- The effect of saffron (Crocus sativus L.) supplementation on blood pressure, and renal and liver function in patients with type 2 diabetes mellitus: A double-blinded, randomized clinical trial.
- Drug stewardship in chronic kidney disease to achieve effective and safe medication use.
- Herbal Nephropathy.