Herbal Medicines for Acute Kidney Injury: Evidence, Gaps and Frontiers

Contribution to journal › Article

Valerian Bunel ; Fan Qu ; Pierre Duez ; Qihe Xu

• Overview
• Citation formats

Original language	English
Pages (from-to)	47-66
Number of pages	20
Journal	World Journal of Traditional Chinese Medicine
Volume	1
Issue number	3
DOIs	http://dx.doi.org/10.15806/j.issn.2311-8571.2015.0019
State	Published - 1 Jul 2015

Documents

• Herbal Medicines for Acute Kidney Injury: Evidence, Gaps and Frontiers
  
  create_pdf.aspx_copy.pdf, 375 KB, application/pdf
  14/01/16
  Final published version
  CC BY-NC-ND

King's Authors

• Qihe Xu (Renal Sciences, MRC Centre for Transplantation)

Abstract

Acute kidney injury (AKI) is a major health threat worldwide. The literature on herbal intervention in AKI was searched from English and Chinese databases and reports were critically analyzed in terms of preventing AKI, promoting repair and regeneration, enhancing extrarenal clearance of uremic toxins, and preventing progression to chronic kidney disease (CKD). Altogether, 16 herbal formulae and a few extracts derived from individual herbs were reported to prevent or mitigate AKI in animal models induced by renal ischemia/reperfusion, cisplastin, gentamicin, glycerol, adenine, sepsis or physical exhaustion. Four formulae and six individual herbs were reported to accelerate recovery and/ or to prevent CKD in established AKI animal models. Intrarectal herbal medicines, with or without simultaneous oral administration, were reported in six clinical trials and in an animal model to increase extrarenal clearance of uremic toxins. Additional 13 clinical trials reported oral or intravenous herbal interventions in AKI of different etiologies. Despite recurring problems, notably poor compliance with good practice guidelines for clinical trials and for authentication, naming and quality control of herbal materials, accumulating experimental data on the preventive effects of herbal medicines in AKI look encouraging and urge for better, definitive trials to guide clinical practice. Herbal enemas promoting extrarenal clearance of uremic toxins seem cost-effective, but better clinical evidence is certainly needed before any affirmative recommendation be made for AKI patients without access to dialysis. New frontiers, however, lie in those herbal remedies that promote repair/ regeneration and prevent chronicity after AKI. Recent experimental data suggest that this may be possible.