Effects of turmeric and curcumin in patients on dialysis or using immunosuppressive agents: a systematic review

There is an increased risk of oxidative stress and inflammation in hemodialysis (HD) patients, as well as nephrotoxicity in individuals receiving immunosuppressive drugs. Turmeric (Curcuma longa) and its active compound, curcumin, demonstrate nephroprotective effects through their antioxidant, anti-inflammatory, and anti-apoptotic properties. This article evaluates the effects of turmeric and curcumin as interventions to reduce oxidative stress and inflammation in HD patients and as nephroprotective agents in patients undergoing immunosuppressive therapy. We conducted this systematic review following the PRISMA guidelines. We searched Web of Science, PubMed, and Scopus up to April 9, 2025, using combinations of terms related to turmeric, curcumin, chronic kidney disease, dialysis, and immunosuppressive agents. Only randomized controlled trials (RCTs) and case reports involving human subjects were included. Four colleagues independently screened the studies and extracted the data. Twenty-one studies were included in our analysis, evaluating interventions involving turmeric or curcumin as monotherapy or in combination with other compounds such as quercetin, piperine, and resveratrol. According to high-quality studies, turmeric and curcumin demonstrated antioxidant and anti-inflammatory benefits in HD patients; however, these compounds did not exhibit a lipid-lowering effect. Additionally, they showed a nephroprotective role in users of immunosuppressive drugs. Conversely, a food-drug interaction between immunosuppressive drugs and high doses of turmeric caused nephrotoxicity. Turmeric and curcumin may serve as supportive therapeutic strategies for HD patients and individuals using immunosuppressive drugs. However, larger sample sizes and high-quality trials with longer follow-up periods are necessary to confirm their efficacy.