Introduction
Herb | Country | Gender | Age (yeas) | Reason | Preparation | Renal side effect | Causality | Reference |
---|---|---|---|---|---|---|---|---|
Dioscorea quinqueloba | Korea | male | 52 | cardiovascular disease | Raw extract | biopsy-proven acute interstitial nephritis | Certain | 2014, [14] |
Dioscorea quinqueloba | Korea | male | 51 | for his own health | dug up tubers of D. quinqueloba and drank about 400 mL of juice made from the raw tubers | acute kidney injury | Probable | 2015, [15] |
Dioscorea quinqueloba | Korea | male | 68–58 | Diabetes mellitus and health tonics | extract from tubers | acute kidney injury | Possible | 2011, [16] |
Cape aloes | Soweto, South Africa | male | 47 | to clean his stomach | Taken the remedy by mouth at least three times during the month before admission, with the last dose about 10 days before admission. | acute oliguric renal failure and liver dysfunction | Certain | 2002, [17] |
Glycyrrhiza glabra | Serbia | female | 39 | sterility | ingestion of 50–100 g herbal products which contained licorice, every day for 8 weeks | Acute Renal Failure | Probable | 2010, [18] |
Unknown herbal vaginal pessary | Nigeria | female | 22 | To terminate an unwanted pregnancy | insertion of a locally prepared herb (semi-solid) into her genital tract | oliguric acute kidney injury | Probable | 2017, [19] |
Chenopodium polyspermum | Anatolia region, Turkey | male | 45 | to regulate his blood glucose levels | chronic renal failure | Possible | 2012, [20] | |
Nigella sativa | Turkey | female | 62 | antioxidant or antidiabetic effects | N. sativa tablets for 6 d at approximately 2000 to 2500 mg/d. | acute renal failure | Possible | 2013, [21] |
Tribulus terrestris Avena sativa Panax ginseng Zingiber officinale | Turkey | female | 50 | cardio-protective | 4 different combination herbal medicinal products twice a day for 2 weeks | Acute kidney injury | Possible | 2014, [22] |
African mango (Irvingia gabonensis) | Turkey | female | 42 | slimming purposes | Three months previously she started using 2 × 500 mg African mango | rapid renal progression | Probable | 2015, [23] |
Lawsonia inermis | Myanmar | male | 34 | swelling of his face and unhealthy appearance of his skin. | boiled henna leaves, of which he drank about 700 mL/ day for 3 days | acute kidney injury | Probable | 2017, [24] |
Lawsonia inermis L. | Kingdom of Saudi Arabia | male | 32 | chronic bloating and constipation | ingestion of large amounts of boiled henna | acute renal failure | Probable | 2013, [25] |
Artemisia herba-alba | Tunisia (North Africa) | male | 59 | antidiabetic agent | aqueous extract (two cups a day for two consecutive days) | acute tubular necrosis | Possible | 2010, [26] |
Euphorbia paralias | Tunisia | male | 29 | edema | one time ingestion of boiled plant of Euphorbia paralias ten days before | acute renal failure | Possible | 2013, [27] |
Cassia senna L. | Belgium | female | 52 | constipation | had ingested, for > 3 years, one liter of an herbal tea each day made from a bag containing 70 g of dry senna fruits | acute hepatic failure and renal impairment | Possible | 2005, [28] |
ayurvedic powder | India | male | 33 | eczematous skin lesions | Ingesttion of ayurvedic contained arsenic for last 6 months | acute kidney injury | Possible | 2011, [29] |
ayurvedic medication | India | female | 44 | to reduce the side effects of chemotherapy | Contained high levels of several heavy metals including those of mercury, lead, and manganese | acute renal failure | Possible | 2015, [30] |
ayurvedic supplement | India | male | 24 | fever and abdominal pain | Ingestion of Alternative Medicine Containing Lead | acute kidney injury | Possible | 2019, [31] |
Carica papaya | India | male | 62 | increase the platelet count | juice extracted from papaya leaves | acute kidney injury | Possible | 2019, [32] |
Tribulus terrestris | Iran | male | 28 | to prevent kidney stone formation | 2 L of T. terrestris water in two consecutive days | nephrotoxicity | Probable | 2010, [33] |
Aristolochia manshuriensis | chine | male | 41 | urinary tract infection | 4 boxes (each containing 40 small packets) of an herbal preparation called “Fen Qing Wu Lin Wan”. That was taken twice daily for twenty consecutive days. | died in renal failure | Certain | 2010, [34] |
Trigonella foenum-graecum | Iran | female | 62 | daily ingestion of heat extract of fenugreek | acute interstitial nephritis | Possible | 2017, [35] | |
Crataegus orientalis | Turkey | male | 68 | eating ½ kg of raw and drinking five cups of tea made from leaves 3 days before | Acute renal failure | Possible | 2008, [36] | |
Tripterygium wilfordii HookF | Southwest china | male | 36.6 | ingesting approximately 50 g of wild honey | 3 patients were at different degrees of renal damage, and 1 patient with severe symptoms died of acute renal failure 1 day after admission | Not excluded | 2016, [37] | |
Colchicum autumnale | Croatia | male | 62 | ate a salad of plant with green leaves regarded as wild garlic | nephrotoxic acute tubular necrosis | Possible | 2004, [38] | |
Rheum rhaponticum | Germany | female | 52 | increased ingestion of approximately 500 mg of rhubarb (fresh weight) per day in the last 4 weeks | acute renal failure | Possible | 2012, [39] | |
Pithecellobium jeringa | Malaysia | male | 45 | acute renal failure | Not excluded | 2007, [40] |
Materials and methods
Search strategy
Inclusion and exclusion criteria
Study selection and data extraction
Results
Description of studies included
Adverse effects of herbal medicines and need of phythovigilance
Case reports of renal side effects associated to herbs usage worldwide
Why is Phytovigilance of nephrotoxic herbal medicines important in nephrology?
Recommendations | Reference |
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medicinal plants are associated with the pathogenesis of renal diseases in order to update healthcare practitioners to keep abreast with the current information on the medicinal herbal therapies and consequences that may be associated with such health-seeking behaviors | [41] |
Some evidence was in line with the potential nephrotoxicity of plants and their reformers. Despite the lack of clinical research for evaluation of their renal damage, the herbs may be focused in term of their nephrotoxicity; and there is a need for further studies on the scientific basis of their nephrotoxicity | [42] |
Strict controls on the presence of adulterants within herbal medicines, labeling of dosages and contraindications, and manufacturing techniques must be maintained to ensure the safety of those consuming herbal medicines. | [43] |
Clinicians should consider herbal medicine use in patients with unexplained acute kidney injury or progressive chronique kidney disease. In addition, exposure to herbal medicine containing aristolochic acid may increase risk for future uroepithelial cancers, and patients require appropriate postexposure screening | [44] |
it is important that alternative medicines not be demonized as a whole, but that their use and consequences be closely observed and reported to build a more comprehensive understanding of their impact in our clinical practice and to foster research on the potential harm or, in some cases, possible benefits | [45] |
Considering the complexity of the toxic components and the diversity of their acting pathway, a lot of work needs to do on pharmacovigilance, “Omics” technologies, and administration of mixtures alleviating toxicities. Pharmacovigilance methods can be used for monitoring kidney toxicity traditional Chinese medicines safety. “Omics” technologies have the potential for the development of molecular markers hopefully allowing for detection of early changes in toxic kidney injury with high sensitivity and specificity. These researches may help us to deeply learn the mechanism of traditional Chinese medicines renal toxicity at the molecular and gene level | [46] |
Use of modern cell biological, biochemical, in vitro and in vivo techniques for the evaluation of medicinal plants safety is needed | [47] |
Herbal medicines related to either severe or moderate adverse events supported by a case report should be avoided. | [48] |
Cooperation between orthodox physicians and traditional practitioners is needed to bring together the full case details. Independent scientific assistance on toxicological investigation, botanical verification can be invaluable for full evaluation of any case report. Systematic pharmacovigilance is essential to build up reliable information on the safety of herbal medicines for the development of appropriate guidelines for safe effective use | [7] |
It is deemed necessary that a basic knowledge of the pharmacological aspects of phytotherapy be included in the regular Course of Medicine. | [49] |
Phytovigilance: A medical requirement and a legal obligation | [8] |
Need to incorporate pharmacovigilance of herbal medicine to the curriculum | [50] |
There is a need for herbal medicine regulation, technical and training assistance, and funding as being major challenges to HM pharmacovigilance in countries. Particular attention to the development of pharma- covigilance of herbal medicine is required in Africa. | [6] |
The use of indigenous drugs, herbal medicine and traditional materiamedica can only be understood through a combination of historical, ecological, economic, cognitive, and pharmacolog- ical approaches, while anecdotal references are lost in space and time. | [51] |
A demonstration of the safety of herbal medicines for registration purposes should include at least in vitro and in vivo genotoxicity assays, long-term rodent carcinogenicity tests (for drugs intended to be continuously used for > 3 months or intermittently for > 6 months), reproductive and developmental toxicity studies (for drugs used by women of childbearing age), and investigation of the effects on drug-metabolizing enzymes. | [52] |
Government organizations should assume responsibility to provide active guidance and effective regulation | [53] |