Nephrotoxicity of Herbal Medicine and Its Prevention

Abstract

Herbal medicine (HM) has been widely used to treat diseases for thousands of years and has greatly contributed to the health of human beings. Many new drugs have been developed from HM, such as artemisinin. However, artemisinin has adverse effects, such as renal toxicity. In 1993, a study conducted in Belgium reported for the first time that the root extracts of Aristolochia obliqua S. M. Hwang led to progressive interstitial renal fibrosis. The nephrotoxicity of HM has attracted worldwide attention. More than 100 kinds of HM induce renal toxicity, including some herbs, animal HMs, and minerals. This paper aimed to summarize the HM compounds that cause nephrotoxicity, the mechanisms underlying the toxicity of these compounds, biomarkers of renal injury, and prevention strategies. These findings provide a basis for follow-up studies on the prevention and treatment of HM nephrotoxicity.

Protective Effects of Mitochondrial Uncoupling Protein 2 against Aristolochic Acid I-Induced Toxicity in HK-2 Cells

“…Herbal medicine involves the use of natural compounds, which have relatively complex active ingredients with varying degrees of side effects [ 31 , 32 , 33 ]. Many herbs which are found to cause nephrotoxicity exert toxic effects by inducing apoptosis in the renal tubular cells.…”

Long-term toxicological studies on the Chinese medicine 2036 Specialty-Qiangxin recipe in rats

“…Thus, the longterm use of 1.2 g/kg 2036S-QXR is relatively safer. Since the kidney is the most vulnerable to herb plants (Xu et al 2020), it is necessary to take precautions to prevent nephrotoxicity during the long-term administration of 2036S-QXR.…”

“…However, the toxicity of herb plants has been underestimated, and there is inadequate information regarding the safety and toxicity risks associated with their use (Charen & Harbord 2020;Liu et al 2020). It has been reported that herb plants may cause adverse effects, such as hepatotoxicity and nephrotoxicity when consumed repeatedly over a long period (van Quan et al 2020;Xu et al 2020). Thus, it is necessary to evaluate the toxicity profile of herb plants to provide recommendations regarding their safe use.…”

“…2020 ; Xu et al. 2020 ). Thus, it is necessary to evaluate the toxicity profile of herb plants to provide recommendations regarding their safe use.…”

Small molecules of herbal origin for osteoarthritis treatment: in vitro and in vivo evidence

“…Lastly, certain herbs have potentially toxic effects on the liver and kidneys. For instance, berberine and coumarin have potential hepatotoxicity, and β-escin and aristolochic acid may cause nephrotoxicity [ 121 ]. Standardized and comprehensive toxicity studies will be necessary to verify the safety of the compounds for clinical application.…”