Table 5.
Some herbal remedies capable of interacting with other drugs via alteration in renal functions.
| Medicinal plants | Brief description | Mechanism | LE | Reference |
|---|---|---|---|---|
| Aristolochia fangchi | Chinese slimming herbal remedy | Aristolochic acid content forms DNA adducts in renal tissues leading to extensive loss of cortical tubules | 4 | Lai et al. (2010) |
| Djenkol bean (Pithecellobium lobatum) | Pungent smelling edible fruit, used for medicinal purposes in Africa | Contains nephrotoxic djenkolic acid | 3 | Luyckx and Naicker (2008), Markell (2010) |
| Impila (Callilepis laureola) | Popular South African medicinal herb | Causes damage to the proximal convoluted tubules and the loop of henle, shown to be hepatotoxic | 3 | Steenkamp and Stewart (2005) |
| Wild mushrooms | Widely consumed in Africa | Some species especially Cortinarius contains nephrotoxic orellanine | 3 | Wolf-Hall (2010) |
| Licorice root (Glycyrrhiza glabra) | Leguminous herb native to Europe and Asia, root and extracts are used in chronic hepatitis and other ailments | Contains glycyrrhizic acid whose metabolite, glycyrrhetinic acid inhibits renal 11-hydroxysteroid dehydrogenase leading to a pseudoaldosterone-like effect – accumulation of cortisol in the kidney, stimulation of the aldosterone receptors in cells of the cortical leading to increased BP, sodium retention, and hypokalemia. This may potentiate the action of drugs such as digoxin | 4 | Isbrucker and Burdock (2006), Kataya et al. (2011) |
| Noni fruit (Morinda citrifolia), alfalfa (Medicago sativa), Dandelion (Taraxacum officinale), horsetail (Equisetum arvense), stinging nettle (Urtica dioica) | These plants and their extracts are used variously in traditional medicine, and have been shown to contain very high potassium levels | Hyperkalemic, hepatotoxic | 3 | Saxena and Panbotra (2003), Stadlbauer et al. (2005), Jha (2010) |
| Rhubarb (Rheum officinale) | Used as laxative | High oxalic acid content may precipitate renal stone formation and other renal disorders | 1 | Bihl and Meyers (2001) |
| Star fruit (Averrhoa carambola) | A tree popular in Southeast Asia and South America employed traditionally as antioxidant and antimicrobial | Oxalate nephropathy | Chen et al. (2001), Wu et al. (2011) | |
| Uva ursi (Arctostaphylos uva ursi), goldenrod (Solidago virgaurea), dandelion (Taraxacum officinale), juniper berry (Juniperus communis), horsetail (Equisetum arvense), lovage root (Levisticum officinale), parsley (Petroselinum crispum), asparagus root (Asparagus officinalis), stinging nettle leaf (Urtica dioica), alfalfa (Medicago sativa) | Various plants used as diuretics | Plants have diuretic property1 and may increase the renal elimination of other drugs | 1 | Dearing et al. (2001), Wojcikowski et al. (2009) |
LE, level of evidence.
1Some of these herbs exert their diuretic effects via extra-renal mechanisms with no direct effects on the kidneys (see Dearing et al., 2001).