Renoprotective Effects of Lime Extract in Diabetic Kidney Disease: A Translational Study from Bench to Bedside

Background: Diabetic kidney disease (DKD) is a major microvascular complication of diabetes mellitus and a leading cause of chronic kidney disease (CKD) and end-stage renal disease worldwide. Albuminuria is one of the most risk for kidney progression. Citrus fruits, particularly lime (Citrus aurantifolia), are rich in flavonoids, polyphenols, and ascorbic acid, which possess antioxidative, anti-inflammatory, and vasoprotective properties. This study aimed to explore the renoprotective effects of a standardized lime extract on albuminuria and kidney injury in both experimental diabetic rats and patients with type 2 diabetes and CKD. Methods: Animal study was conducted in diabetic Wistar rats inducted by streptozotocin and high fat diet. Lime extract-treated rats were fed with 0.6 g LN daily for 12 weeks. Parallelly, a randomized, placebo-controlled clinical trial was conducted in diabetic patients including 31 volunteers in Placebo group receiving 15 g maltodextrin, and 28 volunteers in LN group taking 15 g LN for 6 months. Results: In diabetic rat model, supplementation significantly improved insulin resistance, and reduced urinary albumin excretion. In diabetic volunteer, participants receiving the lime extract for six months demonstrated a significant 29.6% reduction in urinary albumin-to-creatinine ratio (UACR) compared to baseline, whereas the placebo group showed no significant change. No adverse effects on serum creatinine, estimated glomerular filtration rate, electrolytes, or fasting blood sugar were observed. Conclusion: These findings suggest that lime-derived bioactive compounds may provide a safe and effective adjunct therapy for mitigating albuminuria and preserving renal function in patients with diabetic kidney disease. Funding: Government Support – Non-U.S.