Chronic Kidney Disease

CKD is a clinical condition, where kidney function slowly impairs causing build-up of toxic metabolites. Two main causes of CKD are chronic hypertension and diabetes. CKD is often slow progressing and can take up to 15-20 years to show symptoms.

Cannabis can benefit in CKD in various ways. Firstly, THC is a strong hypotensive (reduces BP) which can help in reducing the pressure on kidneys. Various compounds like CBD, CBG, terpenes and flavonoids are strongly anti-inflammatory and can thereby slow disease progression by reducing inflammation.

As discussed in another section, cannabis can modify diabetes symptoms in various ways thereby indirectly improving kidney function. Pain prevalence among patients with CKD and ESRD is as high as 50% where cannabis can help greatly.

Dialysis induced nausea and vomiting is seen mainly in patients with urea built up. An optimal CBD: THC ratio can help mitigate this without side-effects from the THC (like sedation). CBD has also been shown effective against uremia induced pruritis (skin itching). When locally applied, it can reduce the release of histamine (by decreasing nerve activation).

One-quarter to one-half of patients with CKD experience chronic symptoms such as pain, nausea, anorexia, sleep disturbance, anxiety, and depression [69], several of which are approved indications for medical cannabis.

Reference:

Dvorak M, Watkinson A, McGlone F, et al. Histamine induced responses are attenuated by a cannabinoid receptor agonist in human skin. Inflamm Res. 2003;52(6):238-245.

Schlosburg J, O’Neal S, Conrad D, et al. CB1 receptors mediate rimonabant-induced pruritic responses in mice: investigation of locus of action. Psychopharmacology. 2011;216(3):323-331.

A Review of Cannabis in Chronic Kidney Disease Symptom Management. Claudia Ho et al. Can J Kidney Health Dis. 2019; 6: 2054358119828391. Published online 2019 Feb 22. doi: 10.1177/2054358119828391

The nephrologist's guide to cannabis and cannabinoids. Joshua L. Rein. Curr Opin Nephrol Hypertens. 2020 Mar; 29(2): 248–257. Published online 2020 Jan 12. doi: 10.1097/MNH.0000000000000590