Melatonin, a new tool against chronic kidney disease and associated risk factors?

Greece: The combined use of stem cells with melatonin is an appealing therapeutic approach in chronic kidney disease (CKD) which ought to be assessed further, researchers state in a narrative review published in the American Journal of Nephrology. 

The incidence of chronic kidney disease (CKD) is increasing as a consequence of the high prevalence of type 2 diabetes mellitus (T2DM) and arterial hypertension. This warrants the need to develop effective treatment approaches. In this aspect, the pineal gland-derived hormone melatonin may be an appealing treatment approach for CKD and its associated risk factors. 

Melatonin (MT) is a hormone produced mainly in the pineal gland but also in most human tissues. As evidenced through experimental and clinical studies, it may interact with the pathophysiology of kidney diseases and their associated risk factors. In the narrative review, Rigas G. Kalaitzidis, Center for Nephrology "G. Papadakis", Piraeus, Greece, and colleagues focus on the role of melatonin in these pathologic states and the therapeutic potential of its supplementation.

"Melatonin, the primary darkness hormone, possesses pleiotropic mechanisms of action which may have important implications in various pathologic states since its receptors are situated across various organ systems," the authors wrote in their study. "Melatonin may be effective in reducing both daytime and nocturnal blood pressure by influencing endothelial function, oxidative stress, the autonomic nervous system, and the renin-angiotensin system as a treatment tool in arterial hypertension." 

Melatonin may also increase β-cell function and insulin sensitivity. However, late meal intake may be harmful to glucose regulation, as consumption close to melatonin peak concentrations may induce insulin resistance and hyperglycemia, the authors noted. These findings may explain the "inconsistent glycose regulation achieved with melatonin in clinical trials and meta-analyses," they explained. "Also, the presence of genetic variants to melatonin receptor 2 may predispose to the development of T2DM."

The authors concluded the study by writing, "we present the available preclinical evidence supporting melatonin's efficacy in ameliorating CKD's pathophysiology since melatonin supplementation has not been adequately explored in patients with CKD." 

"The combined use of stem cells with melatonin is an appealing therapeutic approach that ought to be assessed further," they wrote.

Reference:

Theofilis, Panagiotis, et al. "The Role of Melatonin in Chronic Kidney Disease and Its Associated Risk Factors: a New Tool in Our Arsenal?" American Journal of Nephrology, 2022, pp. 1-10.