Mechanisms and Efficacy of Chinese Herbal Medicines in Chronic Kidney Disease

Abstract

As the current treatment of chronic kidney disease (CKD) is limited, it is necessary to seek more effective and safer treatment methods, such as Chinese herbal medicines (CHMs). In order to clarify the modern theoretical basis and molecular mechanisms of CHMs, we reviewed the knowledge based on publications in peer-reviewed English-language journals, focusing on the anti-inflammatory, antioxidative, anti-apoptotic, autophagy-mediated and antifibrotic effects of CHMs commonly used in kidney disease. We also discussed recently published clinical trials and meta-analyses in this field. Based on recent studies regarding the mechanisms of kidney disease in vivo and in vitro, CHMs have anti-inflammatory, antioxidative, anti-apoptotic, autophagy-mediated, and antifibrotic effects. Several well-designed randomized controlled trials (RCTs) and meta-analyses demonstrated that the use of CHMs as an adjuvant to conventional medicines may benefit patients with CKD. Unknown active ingredients, low quality and small sample sizes of some clinical trials, and the safety of CHMs have restricted the development of CHMs. CHMs is a potential method in the treatment of CKD. Further study on the mechanism and well-conducted RCTs are urgently needed to evaluate the efficacy and safety of CHMs.

Silymarin and Vanillic Acid Silver Nanoparticles Alleviate the Carbon Tetrachloride-Induced Nephrotoxicity in Male Rats

“…Herbal medicine appeared great benefits in nephroprotection to protect kidneys against different types of injuries to avoid dialysis or transplantation, which are the main treatment methods nowadays [13,14]. On the other hand, incorporating vegetables and fruits rich in antioxidants in the diet improves kidney health and delays chronic kidney failure by reducing inflammation and hampering reactive oxygen species (ROS) formation [15,16].…”

Natural products from plants and microorganisms: Novel therapeutics for chronic kidney disease via gut microbiota regulation

“…First of all, even though many bioactive components from herbal medicine were identified through modern technology including standardized phytochemistry, pharmacology, pharmacokinetics, pharmacodynamics, and toxicology research procedures ( Lin T. L. et al, 2021 ), the bottleneck barrier of herbal medicine development i.e., investigating how the complex ingredients in herbal medicines work together in a synergistic pattern is still not fully elucidated. Second, herbal medicine can avoid the adverse therapeutic effect caused by Western medicine treatment in the clinical practices of CKD treatment ( Zhao et al, 2021 ), but most studies of these herbal medicines are focused on animal experiments. There are few clinical trials about herbal medicine plus first-line Western medicine for CKD treatment except for the multicenter clinical trial of Abelmoschus manihot and irbesartan ( Zhao et al, 2022 ).…”

New Insights Into the Effects of Individual Chinese Herbal Medicines on Chronic Kidney Disease

“…Combining the content of this article and previous literature review ( Zhao, et al, 2020 ; Zhong, et al, 2013 ), we identify that eight Chinese herbal medicine have anti-inflammatory, anti-oxidant, anti-apoptotic effects, reducing extracellular matrix deposition, and anti-fibrosis. Among them, Salvia miltiorrhiza, Rhizoma coptidis, Abelmoschus manihot can interrupt almost all the processes leading to renal fibrogenesis.…”