Introduction
Herbal medicine is common in many countries and has been practiced for decades. Nearly 80 percent of the world’s population relies on herbal medicine for primary health care. These are generally considered safe and preferred due to their natural ingredients. These medications have shown fewer side effects when compared to other synthetic drugs. On the other hand, plants contain many active ingredients that produce physiological effects on the body. This article reveals the nephrotoxicity caused by herbal medicines.
What Are the Compounds That Cause Nephrotoxicity in Herbal Medicines?
There are several compounds in herbal medicines that directly or indirectly cause damage to the kidneys.
Some of the compounds are listed below:
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Aristolochic Acid: Any organic molecule with a carboxyl group besides amino acids is considered organic. Plants contain large amounts of this chemical. Among the organic acids in herbal medicine, aristolochic acid is the most characteristic nephrotoxic component. Renal tubular epithelial cells are susceptible to necrosis and apoptosis when exposed to aspartic acid.
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Alkaloids: Alkaloids are naturally occurring organic compounds, including nitrogen derived from plants. It is a poisonous component of several herbal medicines. Use of these alkaloids in excess or for extended periods has been associated with kidney damage and other negative consequences.
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Terpenoids and Lactoids: In the kingdom of plants, terpenoids and lactones are widely distributed molecules. Terpenoids are derivatives with varying saturation degrees and oxygen content. A single molecule's esterification results in the formation of a lactone, an organic compound having one ester group. They are valuable resources for studying natural products and creating novel medications, and they have significant physiological activity. This material may harm the renal tubulointerstitial system, resulting in uremia and proteinuria in those affected.
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Minerals: Lead, mercury, and arsenic are only a few heavy metals found in most harmful mineral components. When these medications are used in significant doses, metabolic problems cause heavy metals to build up in the kidneys, which damages the kidneys. For instance, renal tubular epithelial cells of the renal cortex undergo apoptosis due to accumulation in the kidney.
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Flavonoid Glycosides: Although generally recognized for their anti-inflammatory and antioxidant qualities, they are not frequently linked to direct nephrotoxicity. Indeed, a number of flavonoids have demonstrated potential renoprotective benefits, supporting kidney function because of their anti-inflammatory and antioxidant characteristics. However, in high concentrations, they are found to cause kidney damage.
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Saponins: Natural chemicals called saponins are present in many plants, but they are especially abundant in herbs such as licorice root, ginseng, and ginkgo biloba. They are utilized in traditional medicine due to their possible health advantages and are well-known for their wide range of biological activity. However, prolonged use can cause nephrotoxicity. Their capacity to induce hemolysis, or the breakdown of red blood cells, is thought to be the mechanism behind their possible nephrotoxic effects. This might result in the release of hemoglobin and subsequent kidney injury. Furthermore, saponins can alter cell membranes and obstruct regular cellular processes, affecting kidney health.
What Is the Mechanism By Which Herbal Medicines Cause Nephrotoxicity?
Herbal remedies have been utilized for their alleged health advantages since ancient times; nevertheless, they can also have negative side effects, such as nephrotoxicity or kidney damage. Although several possible pathways have been suggested, the precise mechanisms by which herbal medications produce nephrotoxicity are unknown.
However, there are the following proposed mechanisms:
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Increased Oxidative Stress: Oxidative stress is a state of imbalance between the body's capacity to neutralize free radicals and the amount of radicals produced. Renal cells are among the cells that free radicals can harm. Certain herbal remedies may worsen oxidative stress and lead to nephrotoxicity.
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Decreased Blood Flow: Herbal medications cause renal damage due to vascular injury, which specifically manifests as damage to the kidney's tubular wall, decreased blood flow, and ultimately, renal tubular atrophy and interstitial fibrosis.
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Apoptosis: Aristolochic acid in some medications causes the release of cytochrome C, which will also raise the amount of free radicals in the mitochondria, alter the activity of protease on the mitochondrial membrane, increase the permeability of the mitochondrial membrane, and have an impact on ATP generation. Cytochrome C enters the cytoplasm, increasing cell oxidation, damaging renal tubular epithelial cells directly, and triggering cell death, particularly in the proximal tubular epithelial cells.
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DNA Damage: Aristolochic acid binds with the DNA of the cells and causes mutations in the P53 gene, affecting the biochemical function of DNA and resulting in damage to the renal peritubular cells.
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Cell Transport Inhibition: Herbal medication may lead to renal inflammation, which can impair the kidney's ability to excrete harmful compounds and increase the buildup of organic anions, ultimately resulting in renal impairment.
How to Prevent the Nephrotoxicity Caused by Herbal Medicines?
To lower the possibility of nephrotoxicity from herbal medications, it's critical to:
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Consult the Physician: To ensure that herbal remedies are safe for particular individuals, consult a physician before using any.
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Begin with Small Doses: Always begin with small doses. Because of delayed metabolism, excessively large doses allow the body to accumulate toxic components, which, over time, will harm the kidneys. As needed, progressively raise the dosage of herbal remedies from low starting points.
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Avoid Using Herbal Medications for Extended Periods of Time: Consult the doctor before using herbal remedies for extended periods.
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Lack of Understanding of Herbal Medications: Due to a lack of knowledge of herbal medications, users may misuse the prescriptions, which might lead to herbal medication abuse or overuse and eventually renal damage.
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Recognize Possible Combinations: Recognize the possibility of interactions between herbal remedies and other medications one uses.
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Please Report Any Negative Impacts: Inform the physician of any negative effects of using herbal remedies.
Conclusion
Certain herbal medications may be harmful to kidney health, even if they provide a natural option for treating and maintaining health. Safeguarding kidney function when using herbal medicines requires knowledge of the possible nephrotoxicity of various herbs and their causes and adopting appropriate safeguards through consultation and responsible usage. The use of herbal medications is still dependent on taking educated and cautious measures, just as with any health issue.
