Is Herbal Medicine Safe in Kidney Disease?

If you suffer from kidney disease or have chronic kidney failure, you may have considered trying herbal medicine to support kidney function. However, the question of safety is commonly raised when it comes to herbal medicine in kidney disease. As a general rule, most nephrologists would recommend against the use of natural medicines, particularly in the case of herbal medicine. This is echoed by bodies such as the National Kidney Foundation who caution against the use of herbal medicine for people with kidney disease. Nevertheless, herbal medicines can be used safely in kidney disease. For myself personally, it has been a crucial component for maintaining kidney function and addressing many of the symptoms associated with kidney failure. However, it is essential to get advice by a practitioner experienced in the management of kidney disease.

One of the main cautions with herbal medicine in kidney disease is that some plants have nephrotoxic effects – they can cause kidney damage. The best-known case of this happened in Belgium where a mini epidemic of kidney failure occurred due to a Chinese herbal slimming supplement sold at a weight loss clinic containing a nephrotoxic plant. There are other instances of nephrotoxicity due to herbs, but the majority of these have been plants not commonly prescribed as herbal medicines (de Johnge & Vanrenterghem, 2007). You are much more likely to develop kidney damage due to pharmaceutical drugs than medicinal herbs. Research indicates that drug-induced nephrotoxicity occurs in approximately 14-26% of adult populations (Awdishu & Mehta, 2017). However, it is important to only use herbal suppliers that independently test every batch of herbs for the purity of the product and to ensure there are no contaminants.  (Singh & Prakash, 2011)

Further concern for the use of herbal medicines in kidney disease is due to pharmacological actions of herbs that may exacerbate your condition. These include herbs that affect potassium levels, have diuretic activity, or interact with pharmaceutical drugs such as immune-suppressants post-transplant. This should not be a deterrent for the use of herbs, however, it does require an experienced and knowledgeable practitioner for appropriate prescribing. (Singh & Prakash, 2011)

So, why would you use herbal medicine for chronic kidney disease?

There are a whole range of benefits for the use of appropriately prescribed herbs. Here are some of the main benefits:

  • Nephroprotective Effects: Many herbs have demonstrated ability to protect the kidney from damage. The use of nephroprotective herbs can prevent further kidney injury and help retain function.
  • Anti-Inflammatory Action: Specific herbs can help decrease or prevent inflammation in the kidney that can contribute to damage and disease progression.
  • Improve Kidney Function: Some herbs have been show to promote kidney function in a variety of ways, including those that encourage kidney blood flow.
  • Reduced Side Effects: There are a number of herbs that are useful for addressing side-effects associated with kidney failure. These include reducing uremia and proteinuria that commonly occurs in late stage renal failure. They can also assist in reducing side effects of dialysis and improving transplant outcomes.
  • Adaptogenic Effects: There are a variety of herbs that have the ability to support energy and reduce fatigue, which is common with late-stage kidney failure. Some of these herbs can also be useful for preventing or reducing anaemia associated with kidney failure. (Yarnell & Abascal, 2007)

Recommendations if considering herbal medicine in kidney disease:

  1. Consult with a qualified naturopath or herbalist experienced in the management of chronic kidney disease and renal failure.
  2. Only use herbal medicines from suppliers that independently test every batch of extracts produced to ensure correct plant material that is free of contaminants and substitutions.
  3. Only use herbs that have a good safety profile or have sufficient evidence for the use in kidney disease.
  4. Be aware that alterations to metabolism of herbs and nutritional supplements may occur with reduced kidney function so this should also be considered when prescribing.
  5. Electrolyte balance is commonly altered in later stage renal failure, so it is essential to avoid herbs that may exacerbate these imbalances.
  6. Discuss any current or planned medication with your herbalist or naturopath to avoid negative herb-drug interactions.

Herbal medicine can provide a range of benefits in kidney disease, including supporting function and preventing further damage, along with reducing side effects of both kidney disease and dialysis. However, it is essential to review with a practitioner experienced in the management of kidney disease, to ensure appropriate and safe prescribing. If you have kidney disease and would like to find out more about how naturopathy may assist, make an appointment via online booking or phone the clinic.

REFERENCES

Awdishu, L. & Mehta, R., 2017, The 6R’s of drug induced nephrotoxicity. BMC Nephrology, 18, 124. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5379580/)

de Johng, H. & Vanrenterghem, Y., 2007, Aristolochic acid: the common culprit of Chinese herbs nephropathy and Balkan endemic nephropathy.Nephrology Dialysis Transplantation, Vol. 23, No. 1. (https://academic.oup.com/ndt/article/23/1/39/1927283)

Singh, N. & Prakash, A., 2011, Nephrotoxic Potential of Herbal Drugs., Journal Medical Sciences Academy, Vol. 24, No. 2. (http://medind.nic.in/jav/t11/i2/javt11i2p79.pdf)

Yarnell, E. & Abascal, K., 2007, Herbs for Relieving Chronic Renal Failure.Alternative and Completmentary Therapies, Vol. 13, No. 1. (https://www.liebertpub.com/doi/10.1089/act.2007.13106))