SAFFRON in my kidney kitchen

by Robin Rose MD

Saffron - Crocus sativus L. - is a member of the Iridaceae family of flowering bulbs that offers us gifts of flavor, color, and plant-based medicine. Saffron is derived from the stigma of the flowers [the whole plant actually has benefits that have been described [3]]. It has been used since the 4th century BC. In fact, it is mentioned in ancient medical texts in 1550 BC as an ingredient included in cures for kidney problems. Other sources mention bladder and kidney infections, kidney stones, circulation, and liver inflammation.

Its' benefits come from its components like crocin [gives the color], picrocrocin [bitter], safranal [volatile], and crocetin. Saffron extract [with crocin and picrocrocin] are known to be protective against ischemia/reperfusion injury. Crocin has been noted to benefit diabetic nephropathy, with improved renal blood flow, acting as a diuretic. Daily hydro-extract [aka tea] has been found to reduce the nephrotoxicity of chemotherapy by slowing down renal excretion.

This plant is carotenoid-rich [crocin] with flavonoids and antioxidants that offer an array of health benefits:

including nerve relaxant, cardioprotective, anti-inflammatory, antiseptic, digestive, anticonvulsant, antispasmodic, aphrodesiac, antibacterial, antifungal, immune- modulating, antidepressant, anxiolytic, antitussive, antinociceptive, and antitumor

The literature has entertained using saffron in conditions like hypertension, dyslipidemia, type 2 diabetes, erectile dysfunction, and liver disease. Saffron's mechanism for reducing oxidative stress includes decreasing MDA [malondialdehyde] and increasing GST [glutathiione S-transferase] - this offers increased antioxidant capacity and free radical scavenging.

Anti-inflammatory effects that can offer help and synergize with the other life-affirming choices we make, may be manifest via crocin, which can decrease pro-inflammatory cytokines like TNFa [tumor necrosis factor a] and IL-6 [interleukin-6]. It decreased uric acid.[7]

Other studies have supported use of saffron for generative maculopathy, depression, anxiety, neurodegenerative diseases, metabolic syndrome, cancer, and chronic kidney disease by promoting glucose metabolisms. Saffron has been shown to address aspects of Alzheimer's and Parkinson's, counteracting neuroinflammation, modulating metabolic pathways of autophagy and apoptosis.

Metabolic syndrome plays a concerning role in kidney disease. Saffron can increase the total antioxidant capacity by reducing malondialdehyde. It decreases production of AGEs [advanced glycemic end products] - AGEs are a known significant CKD hazard. A human study was done [using 100 mg/kg of saffron daily for 12 weeks] --::> antioxidant benefits were celebrated. Another human study found older hypertensive men had improved total cholesterol and decreased inflammation [comparable to resistance training].

Interesting - saffron has shown some positive outcomes due to its anticarcinogenic effects. It was shown to inhibit cell proliferation [3].

With the long haul of chronic kidney disease, we have to find life-supportive allies to include in our day-to-day fare.

Food is medicine becomes a poignant commitment - including herbs and spices in the kidney diet is a precious way to address some of the dangers that cause kidney decline. We know that oxidative stress and inflammation hazard the kidneys - supplementing our menu with dietary herbals known to mediate beneficially is a tasty choice.

Studies have looked at what exactly saffron can do for the kidney. A meta-review explored the possibilities [1] . Creatinine hasn't always been found to decrease from saffron, but BUN does improve. In addition, lipids were improved across the board. Blood glucose lowering is a treasure for keeping diabetic nephropathy at bay [decreasing its damage potential]. It has been described that saffron prevents the re-absorption of renal glucose, with improved insulin production and improved glucose uptake.

Ebrahimi et al. [9] reported that 100 mg of saffron powder significantly improved systolic blood pressure. They reported that this benefit is due to blocking calcium challenge by crocetin. They report thatr crocetin can decrease expression of soluble intercellular adhesion molecule-1 [sICAM-1] which decreases arterial stiffness and thus blood pressure.

Oxidative stress is a target for resolving kidney decline. Crocetins and safranal increase nitric oxide. Crocin can exert a renal vasodilator effect, decreasing creatinine and increasing oxygen delivery. The diuretic action in the distal convoluted tubules contributes to inhibition of sodium and chloride symport [3].

Eye disease is a kidney concern [refer to my book Renology Peptides for detailed awareness in this regard]. Heitmar et al.[5] describe how saffron offers promise as an effective and safe adjunct therapy for many eye diseases. They reviewed the literature and suggested that doses from 20-50 mg appear safe and useful with its pleiotropic array.

Bone is another kidney-success focus. Rekabi et al. found that crocin regulates bone metabolism - maintaining the balance between osteoblasts and osteoclasts [6]. Periodontitis is also a major part of the renology conversation. Plant based medicine offers some tools - crocin offers bone balance and has a role in accumulation of type 1 collagen in teeth and bones. They describe the benefits of saffron/crocin as a reparative and regenerative tool in bone and periodontitis.

Zarei and Elyasi reviewed preclinical studies of saffron as a preventive for drug and toxin-induced nephrotoxicity (their paper is worth reading [4] ). Pre-treatment before chemotherapy was appreciated to be very useful. Combining saffron, cysteine, vitamin E and Nigella sattiva seed neutralized kidney enzyme changes caused by cisplatin - protecting kidneys from the acute injury caused by cancer treatment.

Nephrotoxic drugs can lead to weight loss, proteinuria, reduced urine output, increased sed rate, creatinine, and BUN - saffron can positively impact and protect in this regard. Direct drug-toxicity against the renal tubules causes reactive oxygen species to form, with enhanced elevation of homocysteine when there is folate deficiency. Since the initial tubule damage goes under the lab-test radar, it can be missed - serum creatinine may rise and if not addressed, tubular necrosis is a possible undesireable outcome [4].

Alcohol can damage kidneys. As ethanol metabolizes, free radicals and antioxidants become imbalanced, causing molecular and cellular damage. Excessive alcohol cause can acid-base and elect, and renal necrosis. rolyte disorder, decreased GFR, elevated creatinine and BUN, elevated urinary protein and glucose. Saffron was found to reverse these unpleasant outcomes.

A study was done looking at how saffron can protect kidney from the harsh effects of cadmium. This ubiquitous fiend is in water, food, tobacco smoke, dang even chocolate. As a dietary supplement, it offered protection to industrial workers, with amelioration of nephro- and DNA-genotoxicity. Another study showed saffron to protect from tartrazine.

Saffron is known to be a safe herb, with low toxicity on normal cells. 12.5 grams daily has been noted to be safe[1] - toxicity has been seen in some at doses above 4-5 grams daily, but lethal dose is 20 grams daily. Side effects have been reported at higher doses, included foot swelling, stomach ache, increased appetite, burning eyes, redness and swelling of the eyes and sub-conjuctival hemorrhage [1] . Mention of nausea, poor appetite, headache, dry mouth, insomnia, dizziness has been made - again with higher doses of ~10 grams. Personalized care is always necessary and obligatory!!

Supplements with saffron are available - a quick look shows a dose range from 30- 88.5 mg [studies have shown 20-300 mg] - caution must be had for higher dosing. A quick AI look showed that typical cooking amounts are as follows:

~rice dishes with 10-15 strands of saffron = 10-20 mg per serving

~soups or sauces with 5-10 strands = 5-10 mg per serving

~baked goods with 10-20 strands = 10-25 mg per serving

~tea with 5-7 strands = 5-7 mg per cup

One gram [1000 mg] of saffron = 450-500 strands: each strand is ~2 mg.

KIDNEY DOSING is always something to be concerned with.

~General kidney health and antioxidant support: 30-50 mg/day [7]

~Diabetic nephropathy: 50-100 mg/day [3]

~Drug-induced nephrotoxicity: saffron extract 50 mg/day [4]

~Mild kidney support tea: 5-10 saffron threads in hot water twice daily [9]

The conclusion: saffron is a useful and tasty contribution to a CKD lifestyle, holding back onset and progression. Add it to the joy of kidney cooking.

REFERENCES

1. Karimi E et al. Int J Clin Pract 2022 Aug; 9622546.

2. San, Ayla. Nephrology, Dialysis, Transplantation. May 2018; 33(1):15-16.

3. Marrone G et al. Nutrients 2024: 16(14). 2319.

4. Zarei B & Elyasi S. Iran J Basic Med Sci. 2022Apr; 25(4): 419-434.

5. Heitmar R et al. Nutrients. 2019. 11(3): 649.

6. Rekabi A et al. Open Library of Biosciences. Jan 2024; 51(1): 224.

7. Milajerdi A et al. J Nut & Intermed Metab. Sep 2017;9: 6-11.

8. Nourouzy A et al. International Urology and Nephrology. Feb2022; 54: 2215-2226.

9. Ebrahimi F et al. Avicenna J Phytomed. 2019 Jul; 9(4): 322-333.