AccScience Publishing / GTM / Online First / DOI: 10.36922/GTM025480090
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MINI-REVIEW

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

Kazutomo Sawai1*
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1 Hanshin Medical Co-op Daisan Clinic, Amagasaki, Hyogo, Japan
Global Translational Medicine, 025480090 https://doi.org/10.36922/GTM025480090
Received: 30 November 2025 | Revised: 9 January 2026 | Accepted: 14 January 2026 | Published online: 4 February 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

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.

Keywords
Traditional herbal medicine
Kampo extracts
Glomerular filtration rate
Chronic kidney disease
Funding
None.
Conflict of interest
The author declares no conflict of interest.
References
  1. GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395:709-733. doi: 10.1016/S0140-6736(20)30045-3

 

  1. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2024;105:S117-S314. doi: 10.1016/j.kint.2023.10.018

 

  1. Zhong Y, Deng Y, Chen Y, Chuang PY, Cijiang He J. Therapeutic use of traditional Chinese herbal medications for chronic kidney diseases. Kidney Int. 2013;84:1108-1118. doi: 10.1038/ki.2013.276

 

  1. Wang Y, Feng Y, Li M, et al. Traditional Chinese Medicine in the treatment of chronic kidney diseases: Theories, applications, and mechanisms. Front Pharmacol. 2022;13:917975. doi: 10.3389/fphar.2022.917975

 

  1. Teo WY, Chu SWF, Chow LY, et al. Role of alternative medical systems in adult chronic kidney disease patients: A systematic review of literature. Cureus. 2022;14:e32874. doi: 10.7759/cureus.32874

 

  1. Motoo Y, Arai I, Kogure T, Tsutani K. Review of the first 20 years of the evidence-based medicine committee of the Japan society for oriental medicine. Tradit Kampo Med. 2021;8:123-129. doi: 10.1002/tkm2.1279

 

  1. Jennette JC, D’Agati VD, Fogo AB, Nickeleit V, Barry Stokes M. Heptinstall’s Pathology of the Kidney. 8th ed. Alphen Aan Den Rijn, Netherlands: Wolters Kluwer; 2023.

 

  1. The Editing Committee for Dictionary of Kampo Medicine, the Japan Society for Oriental Medicine. The Dictionary of Kampo Medicine. Kyoto, Japan: Medical Yukon; 2020.

 

  1. Terasawa K. Evidence-based reconstruction of kampo medicine: Part I-Is kampo CAM? Evid Based Complement Alternat Med. 2004;1:11-16. doi: 10.1093/ecam/neh003

 

  1. Terasawa K. Evidence-based reconstruction of Kampo medicine: Part II-the concept of Sho. Evid Based Complement Alternat Med. 2004;1:119-123. doi: 10.1093/ecam/neh022

 

  1. Yamada R, Xu K, Fujimoto M, Kido T. Gaze of Kampo specialists during simulated dynamic abdominal examinations: A cross-sectional study using a wearable eye tracker. Tradit Kampo Med. 2024;11:122-131. doi: 10.1002/tkm2.1409

 

  1. Josa E, Barril G, Ruperto M. Potential effects of bioactive compounds of plant-based foods and medicinal plants in chronic kidney disease and dialysis: A systematic review. Nutrients. 2024;16(24):4321. doi: 10.3390/nu16244321

 

  1. Zheng Y, Ren W, Zhang L, Zhang Y, Liu D. A review of the pharmacological action of astragalus polysaccharide. Front Pharmacol. 2020;11:349. doi: 10.3389/fphar.2020.00349

 

  1. Chan KW, Kwong AS, Tsui PN, et al. Add-on astragalus in type 2 diabetes and chronic kidney disease: A multi-center, assessor-blind, randomized controlled trial. Phytomedicine. 2024;130:155457. doi: 10.1016/j.phymed.2024.155457

 

  1. Tsai YC, Tsai CC, Lin YH, Chang HH, Kuo CY. Chinese herbal medicine in the treatment of chronic kidney disease: A narrative review of mechanisms and therapeutic potential. Iran J Pharm Res. 2025;24(1):e165904. doi: 10.5812/ijpr-165904

 

  1. Li J, Diao L, Li M, Huang F, Sun K. Unraveling the mysteries of the gut-kidney axis: The protective role of traditional Chinese medicine in chronic kidney disease. Front Microbiol. 2025;16:1642377. doi: 10.3389/fmicb.2025.1642377

 

  1. Xiang H, Zuo J, Guo F, Dong D. What we already know about rhubarb: A comprehensive review. Chin Med. 2020;15:88. doi: 10.1186/s13020-020-00370-6

 

  1. Zhang W, Li J, Yang P, et al. Efficacy and safety of Salvia miltiorrhiza for treating chronic kidney diseases: A systematic review and meta-analysis. Evid Based Complement Alternat Med. 2022;2022:2117433. doi: 10.1155/2022/2117433

 

  1. Chen Y, Deng Y, Ni Z, et al. Efficacy and safety of traditional Chinese medicine (Shenqi particle) for patients with idiopathic membranous nephropathy: A multicenter randomized controlled clinical trial. Am J Kidney Dis. 2013;62:1068-1076. doi: 10.1053/j.ajkd.2013.05.005

 

  1. Zhao P, Li Y, Sun Y, et al. Chinese herbal medicine (Tangshen Formula) formula treatment of patients with diabetic kidney disease: A systematic review and meta-analysis. Front Endocrinol (Lausanne). 2025;16:1522759. doi: 10.3389/fendo.2025.1522759

 

  1. Li P, Chen Y, Liu J, et al. Efficacy and safety of Tangshen formula on patients with type 2 diabetic kidney disease: A multicenter double-blinded randomized placebo-controlled trial. PLoS One. 2015;10:e0126027. doi: 10.1371/journal.pone.0126027

 

  1. Zhang H, Yuan C, Sun C, Zhang Q. Efficacy of Jinshuibao as an adjuvant treatment for chronic renal failure in China: A meta-analysis. Medicine (Baltimore). 2023;102(32):e34575. doi: 10.1097/MD.0000000000034575

 

  1. Yu X, Yang J. Factors influencing the efficacy of Shenqi Yanshen granule in ameliorating early proteinuria among patients with nephrotic syndrome: A logistic analysis. Altern Ther Health Med. 2025;31(6):129-133.

 

  1. Wei MY, Jiang YJ, Tang YT, et al. Effectiveness and safety of Tongxinluo capsule for diabetic kidney disease: A systematic review and meta-analysis. World J Diabetes. 2025;16(5):100980. doi: 10.4239/wjd.v16.i5.100980

 

  1. Li P, Lin H, Ni Z, et al. Efficacy and safety of Abelmoschus manihot for IgA nephropathy: A multicenter randomized clinical trial. Phytomedicine. 2020;76:153231. doi: 10.1016/j.phymed.2020.153231

 

  1. Wei LI, Ping X, Wei S, et al. Effects of the Huangkui capsule on chronic kidney disease: A systematic review and Meta-analysis. J Tradit Chin Med. 2023;43(1):6-13. doi: 10.19852/j.cnki.jtcm.2023.01.004

 

  1. Mao W, Yang N, Zhang L, et al. Bupi Yishen formula versus losartan for non-diabetic stage 4 chronic kidney disease: A randomized controlled trial. Front Pharmacol. 2021;11:627185. doi: 10.3389/fphar.2020.627185

 

  1. Zheng Y, Cai GY, He JQ, et al. Efficacy and safety of Niaoduqing particles for delaying moderate-to-severe renal dysfunction: A randomized, double-blind, placebo-controlled, multicenter clinical study. Chin Med J Engl. 2017;130:2402-2409. doi: 10.4103/0366-6999.216407

 

  1. Yoshikawa N, Ito H, Takekoshi Y, et al. Standard versus long-term prednisolone with sairei-to for initial therapy in childhood steroid-responsive nephrotic syndrome: A prospective controlled study. Nihon Jinzo Gakkai Shi. 1998;40(8):587-590.

 

  1. Zhao J, Sun W, Chen J, et al. Efficacy and safety of Chinese herbal formula granules in treating chronic kidney disease stage 3: A multicenter, randomized, placebo-controlled, double-blind clinical trial. Evid Based Complement Altern Med. 2020;2020:4073901. doi: 10.1155/2020/4073901

 

  1. Lin MY, Chiu YW, Chang JS, et al. Association of prescribed Chinese herbal medicine use with risk of end-stage renal disease in patients with chronic kidney disease. Kidney Int. 2015;88:1365-1373. doi: 10.1038/ki.2015.226

 

  1. Sawai K, Yamazaki T, Mine T. Long-term effect of the Japanese herbal Kampo medicine extracts on renal function: A single center propensity score analysis. Tradit Kampo Med. 2025;12:151-159. doi: 10.1002/tkm2.70013

 

  1. Levey AS, Gansevoort RT, Coresh J, et al. Change in albuminuria and GFR as end points for clinical trials in early stages of CKD: A scientific workshop sponsored by the national kidney foundation in collaboration with the US Food and drug administration and european medicines agency. Am J Kidney Dis. 2020;75:84-104. doi: 10.1053/j.ajkd.2019.06.009

 

  1. Motoo Y, Hakamatsuka T, Kawahara N, Arai I, Tsutani K. Standards of reporting Kampo products (STORK) in research articles. J Integr Med. 2017;15:182-185. doi: 10.1016/s2095-4964(17)60347-9

 

  1. Isobe T. Effectiveness of kampo extract formulations in traditional Japanese herbal medicine. J Altern Complement Integr Med. 2023;9:369. doi: 10.24966/acim-7562/100369

 

  1. Uneda K, Yoshino T, Ito H, Imoto S, Nogami T. Current situation and future issues with Kampo medicine: A survey of Japanese physicians. Tradit Kampo Med. 2024;11:156-166. doi: 10.1002/tkm2.1418

 

  1. Japanese Society of Nephrology. Essential points from evidence‑based clinical practice guideline for chronic kidney disease. Clin Exp Nephrol. 2023;28:473-495. doi: 10.1007/s10157-024-02497-4

 

  1. Nishimura K, Osawa T, Watanabe K. Evaluation of oxygen radical absorbance capacity in kampo medicine. Evid Based Complement Alternat Med. 2011;2011:812163. doi: 10.1093/ecam/nen082

 

  1. Hirayama A, Oowada S, Ito H, Matsui H, Ueda A, Aoyagi K. Clinical significance of redox effects of Kampo formulae, a traditional Japanese herbal medicine: Comprehensive estimation of multiple antioxidative activities. J Clin Biochem Nutr. 2018;62:39-48. doi: 10.3164/jcbn.17-59

 

  1. Matsumoto H, Matsumoto A, Miyata S, et al. The effect of Japanese herbal medicines (Kampo) goreisan and saireito on the prevention of recurrent chronic subdural hematoma: A prospective randomized study. Neurosurgery. 2024;94: 80-89. doi: 10.1227/neu.0000000000002649

 

  1. Hirayama A, Tomita T, Nishida T, Nagano Y. Live-imaging analysis of target vessels and nitric oxide production associated with gosha-jinki-gan and keishi-bukuryo-gan: Two herbal preparations with clinically proven blood flow-improving effects but with different traditional clinical indicative patterns. Evid Based Complement Alternat Med. 2022;2022:3821345. doi: 10.1155/2022/3821345
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Global Translational Medicine, Electronic ISSN: 2811-0021 Print ISSN: 3060-8600, Published by AccScience Publishing
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