Nephrotoxicity and Chinese Herbal Medicine

Abstract

Chinese herbal medicine has been practiced for the prevention, treatment, and cure of diseases for thousands of years. Herbal medicine involves the use of natural compounds, which have relatively complex active ingredients with varying degrees of side effects. Some of these herbal medicines are known to cause nephrotoxicity, which can be overlooked by physicians and patients due to the belief that herbal medications are innocuous. Some of the nephrotoxic components from herbs are aristolochic acids and other plant alkaloids. In addition, anthraquinones, flavonoids, and glycosides from herbs also are known to cause kidney toxicity. The kidney manifestations of nephrotoxicity associated with herbal medicine include acute kidney injury, CKD, nephrolithiasis, rhabdomyolysis, Fanconi syndrome, and urothelial carcinoma. Several factors contribute to the nephrotoxicity of herbal medicines, including the intrinsic toxicity of herbs, incorrect processing or storage, adulteration, contamination by heavy metals, incorrect dosing, and interactions between herbal medicines and medications. The exact incidence of kidney injury due to nephrotoxic herbal medicine is not known. However, clinicians should consider herbal medicine use in patients with unexplained AKI or progressive CKD. In addition, exposure to herbal medicine containing aristolochic acid may increase risk for future uroepithelial cancers, and patients require appropriate postexposure screening.

The plant original identification of Inner Mongolia Arnebia Radix based on morphology and DNA barcoding

“…A considerable body of therapeutic drugs were discovered and developed under the backbone of traditional herbal medicines use [56]. Since it is essential that systematic toxicologic studies and the same professional surveillance and strict quality control standards are regularly used for conventional medicines [57], authentication is important to ensure the safety, e cacy and quality control on herbal medicines.…”

Prevalence and risk factors of chronic kidney disease and diabetic kidney disease in a central Chinese urban population: a cross-sectional survey

“…The inadequate awareness and control of diabetes and hypertension has aggravated the health and socioeconomic burden of CKD and DKD in the Chinese population in several aspects, such as lower life expectancy, poor quality of daily life and the high cost of medical care [13][14][15][16]. Insufficient contracts with health services, delayed health-seeking behavior and frequent use of Chinese herbal medicines have also contributed to the high incidence and progression of CKD [17,18].…”

Long Term Effects of Nephrotoxic Medications and the Increased Prevalence of Kidney Disease in the Geriatric Population

“…Herbal medications are commonly used around the country by a number of cultures and ethnicities. Herbal medicine involves the use of natural components that contain a wide variety of multifaceted ingredients that may or may not have varying side effects [10]. Unfortunately, these herbal medications can be known to result in nephrotoxicity [10].…”

“…Herbal medicine involves the use of natural components that contain a wide variety of multifaceted ingredients that may or may not have varying side effects [10]. Unfortunately, these herbal medications can be known to result in nephrotoxicity [10]. There are many factors of herbal medication that can be associated with nephrotoxicity, which includes the intrinsic toxicity of herbs, alterations in the storage and passage of herbs within the kidneys, contamination of heavy metals, incorrect dosing, and the drug interactions of herbal medicine with prescription and OTC medication [10].…”