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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO EDITOR Table of Contents   
Year : 2003  |  Volume : 14  |  Issue : 2  |  Page : 205-206
How Harmless are Herbal Remedies on Human Kidneys?


Division of Nephrology, Post-graduate Department of Medicine, King Fahad Hospital and Tertiary Care Center, Hofuf, Al-Hasa-31982, Saudi Arabia

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How to cite this article:
Saxena AK. How Harmless are Herbal Remedies on Human Kidneys?. Saudi J Kidney Dis Transpl 2003;14:205-6

How to cite this URL:
Saxena AK. How Harmless are Herbal Remedies on Human Kidneys?. Saudi J Kidney Dis Transpl [serial online] 2003 [cited 2019 Jul 22];14:205-6. Available from: http://www.sjkdt.org/text.asp?2003/14/2/205/33032
To the Editor:

The recent increase in the popularity of herbal medicine, especially during the pre­ceding several years has flooded the world's pharmaceutical markets with over 20,000 herbal and other natural products. [1] Herbal medicine is generally for body slimming, musculoskeletal complaints such as back and neck problems, allergies, anxiety, in­somnia, fatigue, impotence and depression. [2]

Herbal products cannot be counted as "natural" and nontoxic as many consumers believe. The Food and Drug Administration (FDA) received 2621 reports of serious medical problems related to herbal medicines, between January 1993 and October 1998. [3] These included allergic reactions, rhabdo­myolysis, hepatotoxicity, hepatic vein thrombosis, nephrotoxicity and mutageni­city as well as 184 deaths.

Recently, nephropathy after ingestion of Chinese herbs has been well documented. A survey in Brussels in 1992-93, for the first time identified nearly 100 patients who suffered from rapidly progressive interstitial renal fibrosis that led to renal failure due to the intake of herbal slimming pills. [4] Thin­layer chromatography of the preparation revealed Aristolochia manshuriensis rich in aristolochic acid (Radix Aristolochiae fangchi, Guang fangji) instead of Stephenia tetrandra (Radix Stephaniae tetrandrae, Fangji). Likewise, the development of renal tubular acidosis with hypokalemic para­lysis, rhabdomyolysis and subsequent acute renal failure was reported from Taiwan, as an atypical presentation of nephrotoxicity of Chinese mixed herbal medicine. [5]

Predialysis patients may be fascinated by herbal drugs because they believe it can help to prevent the progression of their renal disease. Herbal medicine use may be espe­cially hazardous in renal disease because of unpredictable pharmacokinetics and drug interactions. Furthermore, herbal medicine may cause hemodynamic alterations, unpre­dictable effects on blood pressure and glucose, or may potentiate electrolyte abnormalities such as hyperkalemia. There are rarely adequate data on the dialyzability of the active compounds of herbal drugs or their potentially toxic metabolites. Many supplements contain metal ions and other minerals with nephrotoxic potentials. Transplant recipients are also at risk from the unpredictable effects on the immune system. [6]

I believe that there should be accurate documentation of incidence of adverse effects of herbal products on patients with renal disease in Saudi Arabia. This calls for further research for precise infor­mation about herbal drugs in order to maximize consumers' safety and well being.

 
   References Top

1.De Smet PA. Should herbal medicine-like products be licensed as medicines? BMJ 1995;310:1023-4.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Eisenberg DM, Kessler RC, Foster C. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med 1993; 328:246-52.  Back to cited text no. 2    
3.Gugliotta G. Health concerns grow over herbal ads. Washington Post. March 19, 2000:A01.  Back to cited text no. 3    
4.Vanherweghem JL, Depierreux M, Tielemans C, et al. Rapidly progressive interstitial renal fibrosis in young women: association with slimming regimen including Chinese herbs. Lancet 1993; 341:387-91.  Back to cited text no. 4  [PUBMED]  
5.Lee CT, Wu MS, Lu K, Hsu KT. Renal tubular acidosis, hypokalemic paralysis, rhabdomyolysis, and acute renal failure-a rare presentation of Chinese herbal nephropathy. Ren Fail 1999;21(2):227-30.  Back to cited text no. 5    
6.Dahl NV. Herbs and supplements in dialysis patients: panacea or poison? Semin Dial 2001;14(3):186-92.  Back to cited text no. 6    

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Correspondence Address:
Anil K Saxena
Division of Nephrology, Post-graduate Department of Medicine, King Fahad Hospital and Tertiary Care Center, Hofuf, Al-Hasa-31982
Saudi Arabia
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PMID: 18209449

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