Effects of Herbal Supplements on the Kidney

Wendell Combest; Marian Newton; Austin Combest; June Hannay Kosier

Disclosures

Urol Nurs. 2005;25(5):381-386. 

In This Article

Nephro-Protective Herbs and Dietary Supplements

Milk thistle (Silybum marianum) seeds containing several potent antioxidant flavonolignans collectively called silymarin have both hepatic and renal protective effects in rodent models (Combest, 1998). The main constituents composing silymarin are silibinin, silicristin, isosilibinin, and silidianin. Silibinin and silicristin, aside from their antioxidant effects against damaging free radicals, also stimulate RNA and protein synthesis which is important for renal and hepatic repair mechanisms. In addition these same flavonolignans protect kidney cells in culture from the renal toxic effects of the drugs paracetamol, cisplatin, and vincristine (Sonnenbichler, Scalera, Sonnenbichler, & Weyhenmeyer, 1999). Another study in rats demonstrated that silibinin protected renal tubular cells from the oxidative damage from cisplatin (Gaedeke, Fels Bokemeyer, Mengs, Stolte, & Lentzen, 1996). Silibinin also protects against experimental cyclosporine nephrotoxicity (Zima et al., 1998).

Another potentially useful nephro-protective medicinal herb popular in Ayurvedic medicine is picroliv (Picrorhiza kurrooa). Extracts from the roots and rhizomes offer protection against various hepatic and renal toxins. Picroliv protects the kidney in a renal ischemia-reperfusion induced injury (IRI) model in rats (Seth et al., 2000). Pretreatment of rats orally with picroliv for 7 days before initiation of experimental IRI lowered renal lipid peroxidation, reduced apoptosis, and generally increased the viability of renal cells. Another study in rats found that oral administration of picroliv to rats exposed to the carcinogen 1,2 dimethylhydrazine decreased the extent of renal necrosis (Rajeshkumar & Kutton, 2003). As with milk thistle animal studies using picroliv support their potential clinical benefit as nephro-protectants. However, human clinical studies are needed to confirm these Results in cell culture and animal models.

Astragalus (Astragalus membranaceus), a popular herb used in Chinese traditional medicine, is effective against experimentally induced glomerulonephritis in rats, especially in reducing proteinuria (Su et al., 2000). Several clinical studies also showed a reduction in proteinuria in patients with chronic glomerulonephritis by Astragalus (Shi et al., 2002). Cordyceps (Cordyceps sinensis), a fungus found growing in caterpillar larvae of certain moths, has long been valued as a kidney tonic in China (Zhu, Halpern, & Jones, 1998). One study in 61 patients with lupus nephritis showed that a combination of 2 g to 4 g of cordyceps powder together with 0.6 grams of artemisinin from the plant Artemisia annua for 3 years improved kidney function as measured by creatinine clearance (Lu, 2002). Another study found that cordyceps lessened the nephrotoxicity of cyclosporine in kidney transplant patients (Xu, Huang, Jiang, Xu, & Mi, 1995). An anti-oxidant protective mechanism was postulated for this protective effect. The Japanese traditional remedy Sairei-to, a 12 herb mixture, has shown in human and animal studies to protect the kidney in gentamicin renal toxicity, IgA nephropathy, and lupus nephritis (Ohno et al., 1993). Another study in rats showed that extracts from the root of the plant Salvia miltiorriza (Danshen) along with fructose 1-6 diphosphate prevented the decline of renal cortical Na-K-ATPase activity induced by ischemia and gentamicin (Lu & Li, 1989). Further, extracts of the plant Herniaria hirsute inhibit calcium oxalate crystal aggregation and thus could be useful in preventing kidney stone formation (Atmani & Khan, 2000). In summary, there seems to be many potentially protective medicinal plants and supplements that may protect the kidney perhaps via acting primarily as anti-oxidants (see Table 2 ).

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