Cannabinoid pathways may offer targets for kidney disease as CKD affects 850 million people

by Stephanie Baum, Medical Xpress

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Approximately 850 million people globally (9.1% of the world's population) have chronic kidney disease (CKD). The number of affected individuals has grown steadily during the past 20 years and is on track to continue rising. Existing drugs, such as RAAS inhibitors and angiotensin receptor blockers, are commonly prescribed, but their effectiveness varies from patient to patient. Moreover, these drugs can slow disease progression but cannot stop it.

Now, a research team from the Autonomous University of Aguascalientes in Aguascalientes, Mexico, argues that cannabinoid pathways may serve as a novel therapeutic target. Their discussion of this possibility appears in Frontiers in Pharmacology.

CKD mortality and financial burden

The need for new therapies is urgent. Many people with CKD also live with diabetes, high blood pressure and obesity, which collectively account for more than two-thirds of disability-adjusted life years among this population. Overall population aging also plays a part in increasing diagnoses of the disease.

In its later stages, CKD can lead to heart disease and end-stage renal disease (ESRD). The review authors note, "... patients with ESRD can only be treated by dialysis and/or kidney transplant. However, these therapies are insufficient and often hamper the quality of life of patients. For example, patients on dialysis have a higher risk of infection and premature death."

Indeed, a report published in 2019 shows that dialysis can substantially reduce life expectancy. For dialysis patients ages 20–44, life expectancy is approximately 33 years shorter than for age-matched individuals in the general population. For patients ages 45–64, life expectancy is about 21 years shorter.

The 2019 report also shows that transplant patients ages 20–44 have a life expectancy approximately 15 years shorter than that of age-matched individuals in the general population. While the U.S. national transplant list records about 90,000 new patients annually, only 30% (about 27,000) receive a transplant.

The financial impact of these ESRD treatments is also sobering.

"For example, 2–4% of the world's health care budget is allocated to dialysis and kidney transplants even though they represent 0.15% of the total patient population," state the authors of the Frontiers in Pharmacology review.

How CKD progresses at the cellular level

The glomerulus, the kidney's filtration barrier, includes a glomerular basement membrane; fenestrated endothelial cells, which feature tiny pores; and podocytes, specialized epithelial cells whose foot-like extensions help filter blood as they wrap around blood vessels. The glomerulus and renal tubules comprise a nephron, the kidney's basic filtering unit.

As CKD progresses, it diminishes the podocyte basement membrane, decreases the proteins nephrin and podocin, interferes with crucial podocyte foot processes, promotes cell death, and causes tubular fibrosis and collapse.

Interestingly, both glomeruli and renal tubules have been identified as sites of cannabinoid receptors.

"The specific localization of cannabinoid receptors within renal structures, such as glomeruli and tubules, and their physiological actions may reveal their pharmacological utility," the review authors note. "There is evidence in animal models that targeting the cannabinoid receptors could modulate the progression of CKD and AKI [acute kidney injury]."

However, while the human endocannabinoid system (ECS) could represent a new CKD treatment target, reaching this target may not be straightforward.

ECS function within CKD risk factors

The ECS plays a complex role in glucose control, inflammation, obesity and cardiovascular regulation. Mixed results from existing studies point to the need for deeper investigation of how cannabinoids might work in CKD caused by specific conditions.

For example, nearly a third of CKD cases result from diabetes, while high blood pressure causes almost another third. In a 2011 study, blocking CB1 receptors modulated glucose uptake and lipid metabolism but exhibited considerable potential for causing severe mood disorders.

Regarding high blood pressure, the current review cites recent studies showing drops in blood pressure after acute THC administration but noting an association between prolonged THC use and a greater presence of hypertension.

"Therefore, cannabinoids could impact the cardiovascular and metabolic system in opposite directions when targeting kidney disease, for example, decreasing adiposity and insulin resistance on one hand, but inducing hypertension on the other, highlighting the complex role of ECS," the authors write.

Despite such contraindications, the researchers contend that cannabinoids hold promise in kidney disease research. Future work should include in vitro and animal studies as well as multi-organ analysis, they recommend.

Written for you by our author Stephanie Baum, edited by Sadie Harley, and fact-checked and reviewed by Robert Egan—this article is the result of careful human work. We rely on readers like you to keep independent science journalism alive. If this reporting matters to you, please consider a donation (especially monthly). You'll get an ad-free account as a thank-you.

Publication details

Ricardo Romero-Guevara et al, Emerging roles of cannabinoid pathways in renal injury and repair, Frontiers in Pharmacology (2026). DOI: 10.3389/fphar.2026.1777644

Journal information: Frontiers in Pharmacology

Key medical concepts

Chronic Kidney DiseaseKidney Failure, Chronic

Clinical categories

NephrologyClinical pharmacology Who's behind this story?

Stephanie Baum

Stephanie holds a Master's degree in TESOL from The New School in New York, and joined Science X in 2021. Full profile →

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →

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