Renoprotective effect of traditional herbal medicine of ancient Chinese origin: A mini-review

Prevention of chronic kidney disease (CKD) progression represents a critical challenge in global health care. However, the effectiveness of current pharmacologic interventions remains limited, requiring further therapeutic advancements. Traditional herbal medicine (THM) has been used worldwide in the treatment of CKD, but its effect remains uncertain. This review aims to evaluate the efficacy of THM in managing CKD and to identify appropriate methods for assessing its therapeutic effect. A literature search of six databases was conducted. The inclusion criteria comprised (i) ≥100 sample sizes, including retrospective studies, reviews, randomized controlled trials (RCTs), quasi-RCTs, crossover trials, and meta-analyses; (ii) CKD patients as the target; (iii) the use of oral THM as interventions; and (iv) reported primary and secondary outcomes. There were 18 RCTs with 3452 participants, 12 systematic reviews, 4 meta-analyses, and 4 retrospective studies. Although THM improved glomerular filtration rate, its therapeutic effect was uncertain due to major limitations, such as small sample sizes and short follow-up periods. THM formulas are prescribed based on THM diagnosis in a timely manner, meaning that patients sharing the same Western medical diagnosis may receive different formulas, and that prescriptions for a single patient may change during treatment. This approach may be a key reason for the small sample sizes and short follow-up periods of most THM studies against CKD. The use of quality-assured and ready-to-use Kampo extracts in a timely manner may be a promising method for the clinical application of THM in CKD treatment and the evaluation of its actual therapeutic effects.