Nonpharmacologic Strategies to Modulate Nuclear Factor Erythroid 2–related Factor 2 Pathway in Chronic Kidney Disease

Nuclear factor erythroid 2–related factor 2 (Nrf2) is a transcription factor with a high sensitivity to oxidative stress, which regulates the expression of detoxifying enzymes, besides that, can also control antioxidant and anti-inflammatory cellular responses. Therefore, the modulation of this transcription factor can be a new therapeutic approach to reduce complications in chronic kidney disease (CKD) patients, like oxidative stress and inflammation, which leads to increased risk of developing cardiovascular disease, the major cause of death in these patients. Recent studies have shown that nutritional components and physical exercises can regulate the activation of Nrf2; however, very few studies were performed in CKD patients. This review provides an overview about some of the nonpharmacologic strategies that may promote the activation of Nrf2, which may have impact on the human health, particularly in CKD, by preventing oxidative stress and maintaining cellular redox homeostasis.