EXISTING EVIDENCE FOR SAFE USE OF HERBAL MEDICINES IN CHRONIC KINEY DISEASE
There has been a widespread use of herbal medicines in the last two decades, despite a lack of scientific evidence for their efficacy and safety. Health care professionals have expressed growing concerns about safety issues relating to use herbal medicine, particularly in patients with renal or liver insufficiency. This review will propose how to use existing evidence to suggest the safe use of herbal medicines in patients with renal insufficiency, as well as transferring toxicity findings of herbal medicines from animal studies to use in humans.
Safety information from postmarketing surveillance and case reports is likely to be the main information sources. However, there is little data relating to herbal medicines used by patients with chronic kidney disease. When human studies are lacking, animal studies can be seen as a substitute source of reliable information. An animal dose related to renal toxicity is used to calculate a theoretical human equivalent dose in order to estimate the toxicity in humans. However, this information should be used with caution. When herbal medicines used by people with renal insufficiency have, as yet, yielded no evidence of nephropathy, health care providers should regularly monitor kidney function of such people, together with their electrolytes. Observational studies are required to examine the renal adverse effects of herbal medicines.
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