Medicinal herbal extracts – renal friend or foe? Part one: The toxicities of medicinal herbs

In recent years, an increasing percentage of people from industrialized countries have been using complementary and alternative medicines (CAM). This, combined with numerous warnings regarding the potential toxicity of these therapies, suggests the need for practitioners to keep abreast of the reported incidence of renal toxicity caused by the ingestion of medicinal herbs. The goal of the present two-part series, on the toxic or beneficial effects of medicinal herbs on renal health, is to provide practitioners with a summary of the most recent information as well as the means by which evidence for benefit or toxicity has been found. In this first article, we explore in vivo evidence of toxicity. Included are nephrotoxicity from aristolochic acid and other components within herbs, herb--drug interactions resulting in adverse renal effects, and renal toxicity from contaminants within the extracts. The review aims to provide a guide to encourage future toxicity studies and rigorous clinical trials.     

Evidence-based practice: friend or foe?

Chiropractic is an increasingly-recognised health profession and systematic reviews of the effectiveness of manipulation for back pain are responsible for much of that recognition. Establishement on this basis, however demands that the profession learns to operate in the new clinical culture of evidence based practice if it is to progress. This calls for changes in emphases in education for self-monitoring through clinical adit. Evidence based practice can remain a positive factor in the future role of chiropractic provided that the profession and its educators invest meaningfully in arrangements which will allow them to respond to the evidence as it emerges.     

Medicinal herbal extracts – renal friend or foe? Part two: Herbal extracts with potential renal benefits

In this second of two articles regarding the renal toxicities or benefits of medicinal herbs, herbs are reported as being 'potentially beneficial' to the kidneys if there is strong in vivo evidence of renal protection from toxic substances or drugs; potent, specific renal anti-oxidant effects; in vivo cancer antiproliferative effects specific to the kidneys; or in vivo evidence of being beneficial in renal disease or failure. Among the herbs, polyherbal formulae and fungi with potential renal benefits are Cordyceps sinensis, Sairei-to, Rheum spp., Salvia miltiorrhiza and its component, magnesium lithospermate B and others.     

Aprotinin; friend or foe? A review of recent medical literature

Recent articles published in peer review journals have questioned the safety of using aprotinin in patients having heart surgery. Also, evidence has been published to suggest an increase in renal events in patients given aprotinin when compared to those where tranexamic acid was used. The present review will focus principally on the first of these articles in relation to previously published data and experience.