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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

10 supplements

L-Carnitine

L-Carnitine: outcomes studied for End-Stage Renal Disease
GradeOutcomeEffectSizeStudiesPeopleStudies list
Blood Pressure

Small Improvement

Improves (the measure goes down)Small effect1 study1,340 people

Studies that measured blood pressure

Body Mass Index (BMI)

No effect

1 study

Studies that measured body mass index (bmi)

High-density lipoprotein (HDL)

No effect

1 study

Studies that measured high-density lipoprotein (hdl)

Low-density lipoprotein (LDL)

No effect

1 study

Studies that measured low-density lipoprotein (ldl)

Total cholesterol

No effect

1 study

Studies that measured total cholesterol

Triglycerides

No effect

1 study
vLDL-C

No effect

1 study

Cordyceps

Cordyceps: outcomes studied for End-Stage Renal Disease
GradeOutcomeEffectSizeStudiesPeopleStudies list
Blood Urea Nitrogen (BUN)

Small Decrease

Improves (the measure goes down)Small effect2,914 people
C-Reactive Protein (CRP)Improves (the measure goes down)1 study2,914 people

Studies that measured c-reactive protein (crp)

HemoglobinImproves (the measure goes up)2,914 people
Serum AlbuminImproves (the measure goes up)2,914 people

Zinc

  • C-Reactive Protein (CRP): improves
  • Testosterone: improves
  • Luteinizing Hormone: improves
Zinc: outcomes studied for End-Stage Renal Disease
GradeOutcomeEffectSizeStudiesPeopleStudies list
C-Reactive Protein (CRP)

Small Decrease

Improves (the measure goes down)Small effect1 study55 people

Studies that measured c-reactive protein (crp)

TestosteroneImproves (the measure goes up)3 studies95 people

Studies that measured testosterone

Luteinizing HormoneImproves (the measure goes up)95 people
ProlactinImproves (the measure goes up)95 people

Coenzyme Q10

  • Blood glucose
  • Low-density lipoprotein (LDL): improves
  • HbA1c: improves
Coenzyme Q10: outcomes studied for End-Stage Renal Disease
GradeOutcomeEffectSizeStudiesPeopleStudies list
Blood glucose

No effect

1 study

Studies that measured blood glucose

Low-density lipoprotein (LDL)Improves (the measure goes down)4 studies60 people

Studies that measured low-density lipoprotein (ldl)

and 1 more on the Coenzyme Q10 page

HbA1cImproves (the measure goes down)2 studies60 people

Studies that measured hba1c

Total cholesterolImproves (the measure goes down)2 studies60 people

Studies that measured total cholesterol

High-density lipoprotein (HDL)Improves (the measure goes up)1 study60 people

Studies that measured high-density lipoprotein (hdl)

Glycemic ControlImproves (the measure goes up)60 people
InsulinChanges; see studies60 people
TriglyceridesImproves (the measure goes down)60 people
vLDL-CImproves (the measure goes down)60 people

Alpha-Lipoic Acid

  • C-Reactive Protein (CRP)
  • Oxidative Stress Biomarkers: changes; see studies
Alpha-Lipoic Acid: outcomes studied for End-Stage Renal Disease
GradeOutcomeEffectSizeStudiesPeopleStudies list
C-Reactive Protein (CRP)

No effect

NoneNo effect2 studies63 people

Studies that measured c-reactive protein (crp)

Oxidative Stress BiomarkersChanges; see studies4 studies63 people

Studies that measured oxidative stress biomarkers

and 1 more on the Alpha-Lipoic Acid page

Sea Buckthorn

  • C-Reactive Protein (CRP)
  • DNA Damage: changes; see studies
  • Inflammation: improves
Sea Buckthorn: outcomes studied for End-Stage Renal Disease
GradeOutcomeEffectSizeStudiesPeopleStudies list
C-Reactive Protein (CRP)

No effect

NoneNo effect45 people
DNA DamageChanges; see studies1 study45 people

Studies that measured dna damage

InflammationImproves (the measure goes down)45 people

Sodium Bicarbonate

  • Blood Pressure
  • Serum Bicarbonate: improves
  • Kidney Function: improves
Sodium Bicarbonate: outcomes studied for End-Stage Renal Disease
GradeOutcomeEffectSizeStudiesPeopleStudies list
Blood Pressure

No effect

NoneNo effect1,380 people
Serum BicarbonateImproves (the measure goes up)26 studies1,380 people

Studies that measured serum bicarbonate

and 23 more on the Sodium Bicarbonate page

Kidney FunctionImproves (the measure goes up)1 study1,380 people

Studies that measured kidney function

Heart Failure RiskChanges; see studies1,380 people
Leg EdemaChanges; see studies1,380 people

Resistant Starch

  • C-Reactive Protein (CRP)
  • TNF-Alpha: improves
  • Interleukin 6: improves
Resistant Starch: outcomes studied for End-Stage Renal Disease
GradeOutcomeEffectSizeStudiesPeopleStudies list
C-Reactive Protein (CRP)

No effect

NoneNo effect467 people
TNF-AlphaImproves (the measure goes down)1 study467 people

Studies that measured tnf-alpha

Interleukin 6Improves (the measure goes down)467 people
Oxidative Stress BiomarkersImproves (the measure goes down)467 people
Superoxide Dismutase ActivityImproves (the measure goes up)467 people
Total Antioxidant Capacity (TAC)Improves (the measure goes up)467 people

Curcumin

  • Oxidative Stress Biomarkers: improves
Curcumin: outcomes studied for End-Stage Renal Disease
GradeOutcomeEffectSizeStudiesPeopleStudies list
Oxidative Stress BiomarkersImproves (the measure goes down)6 studies167 people

Studies that measured oxidative stress biomarkers

and 3 more on the Curcumin page

Creatine

  • Kidney Function: improves
Creatine: outcomes studied for End-Stage Renal Disease
GradeOutcomeEffectSizeStudiesPeopleStudies list
Kidney FunctionImproves (the measure goes up)5 studies45 people

Studies that measured kidney function

and 2 more on the Creatine page

Key findings

  • Blood PressureL-CarnitineImproves (the measure goes down)
  • Blood Urea Nitrogen (BUN)CordycepsImproves (the measure goes down)
  • C-Reactive Protein (CRP)ZincImproves (the measure goes down)

The End-Stage Renal Disease (Chronic Kidney Disease Stage 5) protocol

2 primary supplements · 5 supporting supplements

See the full protocol

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 supplement graded A or B for End-Stage Renal Disease. Each opens the products we list for that supplement.

  • Grade B

Links to Fullscript, iHerb or Thorne carry our referral, so we may earn a commission at no extra cost to you. Grades come from the research and never change based on what we earn. Fullscript asks for a free account before it shows its catalog and prices. Full disclosure

Studies cited

63 studies from PubMed

  1. Effects of zinc supplementation on serum zinc and C-reactive protein concentrations in hemodialysis patientsJ Ren Nutr · PMID 19541504
  2. Impact of oral zinc therapy on the level of sex hormones in male patients on hemodialysisRen Fail · PMID 20446777
  3. The effect of exhaustion exercise on thyroid hormones and testosterone levels of elite athletes receiving oral zincNeuro Endocrinol Lett · PMID 16648789
  4. Effect of fatiguing bicycle exercise on thyroid hormone and testosterone levels in sedentary males supplemented with oral zincNeuro Endocrinol Lett · PMID 17984944
  5. Pre-exercise alkalosis and acid-base recoveryInt J Sports Med · PMID 18004683
  6. Plasma pH does not influence the cerebral metabolic ratio during maximal whole body exerciseJ Physiol · PMID 21098003
  7. Sodium bicarbonate can be used as an ergogenic aid in high-intensity, competitive cycle ergometry of 1 h durationEur J Appl Physiol Occup Physiol · PMID 10367725
  8. Effect of sodium bicarbonate contribution on energy metabolism during exercise: a systematic review and meta-analysis.J Int Soc Sports Nutr · PMID 33546730
  9. Multiday acute sodium bicarbonate intake improves endurance capacity and reduces acidosis in menJ Int Soc Sports Nutr · PMID 23531361
  10. Sodium bicarbonate ingestion does not improve performance in women cyclistsMed Sci Sports Exerc · PMID 7869886
  11. Effects of caffeine, sodium bicarbonate, and their combined ingestion on high-intensity cycling performanceInt J Sport Nutr Exerc Metab · PMID 22693238
  12. Dose-related effects of prolonged NaHCO3 ingestion during high-intensity exerciseMed Sci Sports Exerc · PMID 17019296
  13. Effects of induced metabolic alkalosis on prolonged intermittent-sprint performanceMed Sci Sports Exerc · PMID 15870629
  14. The effects of serial and acute NaHCO3 loading in well-trained cyclistsJ Strength Cond Res · PMID 23001395
  15. Effect of induced alkalosis on the power-duration relationship of "all-out" exerciseMed Sci Sports Exerc · PMID 19952817
  16. Effect of alkalosis on plasma epinephrine responses to high intensity cycle exercise in humansEur J Appl Physiol · PMID 12012079
  17. Efficacy and safety of oral sodium bicarbonate in kidney-transplant recipients and non-transplant patients with chronic kidney disease: a systematic review and meta-analysis.Front Pharmacol · PMID 39253380
  18. Effect of sodium bicarbonate ingestion on exhaustive resistance exercise performanceMed Sci Sports Exerc · PMID 8396707
  19. Increased blood pH but not performance with sodium bicarbonate supplementation in elite rugby union playersInt J Sport Nutr Exerc Metab · PMID 20739719
  20. Effects of chronic NaHCO3 ingestion during interval training on changes to muscle buffer capacity, metabolism, and short-term endurance performanceJ Appl Physiol · PMID 16627675
  21. Acute versus chronic sodium bicarbonate ingestion and anaerobic work and power outputJ Sports Med Phys Fitness · PMID 11687764
  22. Effects of chronic bicarbonate ingestion on the performance of high-intensity workEur J Appl Physiol Occup Physiol · PMID 10483803
  23. Influence of sodium bicarbonate ingestion on plasma ammonia accumulation during incremental exercise in manEur J Appl Physiol Occup Physiol · PMID 8381081
  24. The effects of buffer ingestion on metabolic factors related to distance running performanceEur J Appl Physiol Occup Physiol · PMID 8851907
  25. Induced metabolic alkalosis affects muscle metabolism and repeated-sprint abilityMed Sci Sports Exerc · PMID 15126714
  26. Effect of induced alkalosis on exhaustive leg press performanceMed Sci Sports Exerc · PMID 9565933
  27. Metabolic and blood catecholamine responses to exercise during alkalosisMed Sci Sports Exerc · PMID 3386500
  28. The acute reversal of a diet-induced metabolic acidosis does not restore endurance capacity during high-intensity exercise in manEur J Appl Physiol Occup Physiol · PMID 8861677
  29. Effects of sodium bicarbonate ingestion on prolonged intermittent exerciseMed Sci Sports Exerc · PMID 12900682
  30. Acid-base balance during repeated bouts of exercise: influence of HCO3Int J Sports Med · PMID 6094373
  31. Effects of various sodium bicarbonate loading protocols on the time-dependent extracellular buffering profileJ Strength Cond Res · PMID 20040895
  32. The effect of sea buckthorn supplement on oral health, inflammation, and DNA damage in hemodialysis patients: a double-blinded, randomized crossover studyJ Ren Nutr · PMID 23131570
  33. The Effects of Resistant Starch on Biomarkers of Inflammation and Oxidative Stress: A Systematic Review and Meta-Analysis.Nutr Cancer · PMID 35188032
  34. Efficacy of antioxidant intervention and exercise intervention for lipid peroxidation in dialysis patients: a meta-analysis.Front Med · PMID 40166056
  35. Six-month randomized, placebo-controlled, double-blind, pilot clinical trial of curcumin in patients with Alzheimer diseaseJ Clin Psychopharmacol · PMID 18204357
  36. Improvement in oxidative stress and antioxidant parameters in beta-thalassemia/Hb E patients treated with curcuminoidsClin Biochem · PMID 19900435
  37. Curcumin protects DNA damage in a chronically arsenic-exposed population of West BengalHum Exp Toxicol · PMID 20056736
  38. Antioxidant and anti-inflammatory effects of curcuminoid-piperine combination in subjects with metabolic syndrome: A randomized controlled trial and an updated meta-analysisClin Nutr · PMID 25618800
  39. The effects of curcumin-containing supplements on biomarkers of inflammation and oxidative stress: A systematic review and meta-analysis of randomized controlled trials.Phytother Res · PMID 30402990
  40. Effect of creatine supplementation on measured glomerular filtration rate in postmenopausal womenAppl Physiol Nutr Metab · PMID 21574777
  41. Creatine supplementation does not decrease total plasma homocysteine in chronic hemodialysis patientsKidney Int · PMID 15569335
  42. Effect of short-term high-dose creatine supplementation on measured GFR in a young man with a single kidneyAm J Kidney Dis · PMID 20060630
  43. Effects of creatine supplementation on renal function: a randomized, double-blind, placebo-controlled clinical trialEur J Appl Physiol · PMID 18188581
  44. Creatine supplementation does not impair kidney function in type 2 diabetic patients: a randomized, double-blind, placebo-controlled, clinical trialEur J Appl Physiol · PMID 20976468
  45. Effects and safety of Ophiocordyceps sinensis preparation in the adjuvant treatment for dialysis patients: a systematic review and meta-analysis.Front Pharmacol · PMID 39101133
  46. The Effects of Coenzyme Q10 Supplementation on Metabolic Profiles of Patients with Chronic Kidney Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials.Curr Pharm Des · PMID 30417782
  47. Effect of coenzyme Q10 on risk of atherosclerosis in patients with recent myocardial infarctionMol Cell Biochem · PMID 12841346
  48. Beneficial Effects of Coenzyme Q10 Supplementation on Lipid Profile and Intereukin-6 and Intercellular Adhesion Molecule-1 Reduction, Preliminary Results of a Double-blind Trial in Acute Myocardial InfarctionInt J Prev Med · PMID 26330989
  49. Treatment of coenzyme Q10 for 24 weeks improves lipid and glycemic profile in dyslipidemic individualsJ Clin Lipidol · PMID 29454678
  50. Coenzyme Q10 improves blood pressure and glycaemic control: a controlled trial in subjects with type 2 diabetesEur J Clin Nutr · PMID 12428181
  51. Coenzyme Q(10) improves endothelial dysfunction of the brachial artery in Type II diabetes mellitusDiabetologia · PMID 11914748
  52. Effectiveness of Coenzyme Q10 Supplementation for Type 2 Diabetes Mellitus: A Systematic Review and Meta-AnalysisInt J Endocrinol · PMID 30305810
  53. Effects of Coenzyme Q10 Supplementation on Metabolic Indicators in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.Clin Ther · PMID 39904656
  54. Clinical trial of the effects of coenzyme Q10 supplementation on glycemic control and markers of lipid profiles in diabetic hemodialysis patientsInt Urol Nephrol · PMID 30251010
  55. Effects of Coenzyme Q10 Supplementation on Lipid Profiles in Adults: A Meta-analysis of Randomized Controlled Trials.J Clin Endocrinol Metab · PMID 36337001
  56. Effects of L-carnitine supplementation on lipid profile in adult patients under hemodialysis: a systematic review and meta-analysis of RCTs.Front Med · PMID 39687901
  57. Effects of L-carnitine supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials.J Hum Hypertens · PMID 31481697
  58. Restoration of blood total glutathione status and lymphocyte function following alpha-lipoic acid supplementation in patients with HIV infectionJ Altern Complement Med · PMID 18315507
  59. Assessment of the antioxidant effectiveness of alpha-lipoic acid in healthy men exposed to muscle-damaging exerciseJ Physiol Pharmacol · PMID 19617657
  60. Alpha-lipoic acid improves endothelial dysfunction in patients with subclinical hypothyroidismExp Clin Endocrinol Diabetes · PMID 20162509
  61. Effects of Alpha-Lipoic Acid Supplementation on Inflammation, Oxidative Stress, and Serum Lipid Profile Levels in Patients with End-Stage Renal Disease on HemodialysisJ Ren Nutr · PMID 21908204
  62. Complementary therapy in diabetic patients with chronic complications: a pilot studyBratisl Lek Listy · PMID 20586147
  63. Effects of alpha-lipoic acid supplementation in peripheral arterial disease: a pilot studyJ Altern Complement Med · PMID 17604563

Supplement stack for End-Stage Renal Disease