| 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. |
