Renoprotective Potential of Bromelain: Mechanisms and Therapeutic Applications in Nephropathy

Nephropathy, resulting from diabetes, drug toxicity, or oxidative stress, is a major contributor to chronic kidney disease worldwide. Natural products with antioxidant, anti-inflammatory, and immunomodulatory properties are gaining attention as potential nephroprotective agents. Bromelain, a cysteine protease derived from pineapple (Ananas comosus), has demonstrated significant renoprotective effects in preclinical models of diabetic, drug-induced, and oxidative stress-related nephropathy. Mechanistically, bromelain attenuates oxidative stress, inflammation, apoptosis, and fibrosis while enhancing antioxidant defense and modulating immune responses. Its favorable safety profile, oral bioavailability, and nutraceutical potential make it a promising adjunct or alternative therapy. However, clinical evidence in human nephropathy remains limited, and challenges such as enzyme stability, standardization, and bioavailability need to be addressed. Future strategies involving nanotechnology-based delivery, combination therapy with other natural products, and precision medicine approaches may enhance its therapeutic potential. This review summarizes the mechanisms, experimental evidence, clinical relevance, and future perspectives of bromelain as a renoprotective agent, highlighting its promise in kidney disease management and the need for further clinical validation.