A systematic review of potential candidates of herbal medicine in treatment of chronic kidney disease

Abstract

BackgroundDue to the toxicity issues of synthetic compounds, herbal medicines are preferred in treating or curing many diseases in recent times. Because of limited treatment options for chronic kidney disease (CKD), the use of traditional herbal medication to alleviate urogenital problems is the alternate therapeutic selection. PurposeHere, we summarized the research outcomes for the use of herbal medicine in the treatment of CKD and hurdles in the way for further research. MethodsA relevant literature based on combinations of keywords such as herbal medicines, Chinese herbal medicine, CKD, chronic renal failure, nephroprotection, renoprotection, vegetable-based diet, and plant-based diets was searched using Pub med, Google Scholar, and Science Direct databases. The original articles published from 2006 to 2021 were taken into consideration. The literature was evaluated by studying the abstract or full text, all irrelevant studies were ignored. ResultsAbout 54 studies were found to describe the utilization of herbal drugs in the treatment of CKD in both human and laboratory animals, 17 studies described the clinical application of about 13 medicinal plants used against CKD in humans and 37 studies demonstrated the beneficial use of 24 medicinal plants in animal models and in vitro studies for CKD treatment explaining possible mechanisms of their action. The herbal treatment displayed anti-inflammatory, antioxidant, chemopreventive, and immune-mediated properties. The anti-inflammatory action is well implicated via regulation of cyclooxygenase-2, signal transducer, and activation of transcription 3 and IκB kinase β pathways. These pathways are being hypothesized to produce convincing results in CKD. The CKD and gut microbiota is known to be closely related through inflammatory, renal, cardiovascular, and endocrine processes. The various concerns encountered during the use of herbal therapy in CKD are unpredictable pharmacokinetics, herbal and physiological interactions, electrolytic imbalance, and interaction with co-morbid conditions. The combined use of Chinese herbal medicine and Western medicine for the treatment of advanced-stage CKD was found to be effective in delaying dialysis initiation and reducing dialysis incidence. ConclusionsA large number of medicinal plants have shown promising beneficial effects against several diseases including cancer, but only a handful of studies are available on CKD. Several studies explained the possible mechanisms of herbal medications in CKD for therapeutic use; however, the focussed molecular studies for identification of active components of medicinal herbs with their mechanism of action and safety standard are still awaited. The demand for well-designed clinical trials and rigorous pharmacological studies as well as a surge for combined use of herbal medicine and Western medicine for the treatment of CKD has been noticed. The nephrotoxicity issues of medicinal plants should not be ignored.