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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Curcumin Therapy to Treat Vascular Dysfunction in Children and Young Adults with ADPKD: A Randomized Controlled Trial
Kristen L Nowak1, Heather Farmer-Bailey1, Wei Wang1
1Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Insights
Curcumin did not improve vascular function or slow kidney growth in children and young adults with autosomal dominant polycystic kidney disease (ADPKD). This study found no benefits of curcumin supplementation for ADPKD patients.
Area of Science:
- Nephrology
- Vascular Biology
- Pharmacology
Background:
- Autosomal dominant polycystic kidney disease (ADPKD) can manifest with vascular dysfunction in childhood.
- Curcumin, a turmeric polyphenol, shows promise in reducing vascular dysfunction and slowing kidney disease in preclinical models.
- Previous research suggests curcumin's potential benefits in non-ADPKD populations and animal models of ADPKD.
Purpose of the Study:
- To investigate the efficacy of oral curcumin therapy in improving vascular endothelial dysfunction and arterial stiffness in pediatric and young adult ADPKD patients.
- To assess curcumin's impact on vascular oxidative stress, inflammation, and kidney growth in this population.
Main Methods:
- A 12-month, randomized, placebo-controlled, double-blind trial involving 68 children and young adults (6-25 years) with ADPKD.
- Participants received either curcumin (25 mg/kg/day) or placebo.
- Coprimary outcomes included brachial artery flow-mediated dilation and aortic pulse-wave velocity; secondary outcomes assessed biomarkers and kidney volume.
Main Results:
- No significant differences were observed in brachial artery flow-mediated dilation or aortic pulse-wave velocity between the curcumin and placebo groups.
- Curcumin supplementation did not lead to a reduction in vascular oxidative stress or changes in mechanistic biomarkers.
- Height-adjusted total kidney volume did not differ between groups, indicating no effect on kidney growth.
Conclusions:
- Oral curcumin therapy did not demonstrate efficacy in improving vascular function or slowing kidney growth in children and young adults with ADPKD.
- The findings suggest that curcumin is not a beneficial treatment for vascular dysfunction or kidney progression in this specific patient group.
Background And Objectives:
Clinical manifestations of autosomal dominant polycystic kidney disease (ADPKD), including evidence of vascular dysfunction, can begin in childhood. Curcumin is a polyphenol found in turmeric that reduces vascular dysfunction in rodent models and humans without ADPKD. It also slows kidney cystic progression in a murine model of ADPKD. We hypothesized that oral curcumin therapy would reduce vascular endothelial dysfunction and arterial stiffness in children/young adults with ADPKD.
Design, Setting, Participants, & Measurements:
In a randomized, placebo-controlled, double-blind trial, 68 children/young adults 6-25 years of age with ADPKD and eGFR>80 ml/min per 1.73 m2 were randomized to either curcumin supplementation (25 mg/kg body weight per day) or placebo administered in powder form for 12 months. The coprimary outcomes were brachial artery flow-mediated dilation and aortic pulse-wave velocity. We also assessed change in circulating/urine biomarkers of oxidative stress/inflammation and kidney growth (height-adjusted total kidney volume) by magnetic resonance imaging. In a subgroup of participants ≥18 years, vascular oxidative stress was measured as the change in brachial artery flow-mediated dilation following an acute infusion of ascorbic acid.
Results:
Enrolled participants were 18±5 (mean ± SD) years, 54% were girls, baseline brachial artery flow-mediated dilation was 9.3±4.1% change, and baseline aortic pulse-wave velocity was 512±94 cm/s. Fifty-seven participants completed the trial. Neither coprimary end point changed with curcumin (estimated change [95% confidence interval] for brachial artery flow-mediated dilation [percentage change]: curcumin: 1.14; 95% confidence interval, -0.84 to 3.13; placebo: 0.33; 95% confidence interval, -1.34 to 2.00; estimated difference for change: 0.81; 95% confidence interval, -1.21 to 2.84; P=0.48; aortic pulse-wave velocity [centimeters per second]: curcumin: 0.6; 95% confidence interval, -25.7 to 26.9; placebo: 6.5; 95% confidence interval, -20.4 to 33.5; estimated difference for change: -5.9; 95% confidence interval, -35.8 to 24.0; P=0.67; intent to treat). There was no curcumin-specific reduction in vascular oxidative stress or changes in mechanistic biomarkers. Height-adjusted total kidney volume also did not change as compared with placebo.
Conclusions:
Curcumin supplementation does not improve vascular function or slow kidney growth in children/young adults with ADPKD.
Clinical Trial Registry Name And Registration Number:
Curcumin Therapy to Treat Vascular Dysfunction in Children and Young Adults with ADPKD, NCT02494141.
Podcast:
This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2022_02_07_CJN08950621.mp3.
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