The Problem
The kidney removes much of the body’s waste products generated by metabolism.  The inability to consistently accomplish this goal results in kidney disease.  Kidney disease is strongly associated with insulin resistance (1). 

The underlying cause of kidney disease is fibrosis (i.e., scar formation) in the kidney tubules, which reduces the ability of the kidneys to remove waste products from the blood into the urine.  In severe cases of kidney disease, the patient requires dialysis to remove waste products from the blood. It has been shown that activation of AMPK in reverses many complications associated with kidney disease (2). 

The Traditional Medical Approach
The leading drugs to treat kidney disease are sodium-glucose co-transporter-2 inhibitors (SGLT2i).  The tradenames of these drugs include Farxiga and Jardiance.  SGLT2 inhibitors work by increasing AMPK levels (3,4).

The Metabolic Engineering® Approach
Many of the drugs used to treat the symptoms of kidney disease can be enhanced by consistent use of Metabolic Engineering® to reduce insulin resistance by activating AMPK activity.  

The goal of Metabolic Engineering® is to reduce insulin resistance by increasing AMPK activity.  Using the Zone diet component of Metabolic Engineering® to restrict calories without hunger or fatigue is the most powerful dietary approach for lowering insulin resistance because of its direct impact on increasing AMPK activity.  The omega-3 fatty acid and polyphenol components of Metabolic Engineering® are indirect activators of AMPK activity.  Thus, combining all three dietary interventions in Metabolic Engineering® provides the optimal approach to maximizing AMPK activity to reduce insulin resistance.

Thus, Metabolic Engineering® works in concert with drug therapy for kidney treatment to help reprogram kidney function by activating AMPK.  This means that Metabolic Engineering® either makes the drug used to improve kidney function work better or allows the physician to potentially decrease the amount of drug used to manage their patient’s kidney disease, resulting in fewer side effects. 

Although Metabolic Engineering® can quickly reduce insulin resistance, eliminating scar tissue caused by prolonged diet-induced inflammation and replacing it with new healthy tissue takes considerably longer.

References
1. Xu, H. and Carrero, J. Insulin resistance in chronic kidney disease. Nephrology, 2017; 22: 31-34. https://doi.org/10.1111/nep.13147

2. Juszczak F, Caron N, Mathew AV, Declèves AE.Critical role for AMPK in metabolic disease-induced chronic kidney disease.  Int J Mol Sci.  2020; 21:7994.doi: 10.3390/ijms21217994.

3. Packer M. Interplay of adenosine monophosphate-activated protein kinase/sirtuin-1 activation and sodium influx inhibition mediates the renal benefits of sodium-glucose co-transporter-2 inhibitors in type 2 diabetes: A novel conceptual framework. Diabetes Obes Metab. 2020; 22:734-742. doi: 10.1111/dom.13961.

4. Safaie N, Masoumi S, Alizadeh S, et al. SGLT2 inhibitors and AMPK: The road to cellular housekeeping? Cell Biochem Funct. 2024; 42:e3922. doi:10.1002/cbf.3922