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ISSN: 2393-9583 (P)/ 2393-9591 (O)
An International Journal of Research in AYUSH and Allied Systems
Review Article
REVIEW ON ROLE OF HERBAL DRUG IN THE PREVENTION AND MANAGEMENT OF KIDNEY
DISEASE
Laxmi Maharana1*, Om Prakash Dadhich2
*1PhD Scholar, 2Dean Academic & H.O.D. P.G. Dept. of Sharir Kriya, National Institute of Ayurveda, Jaipur, India.
KEYWORDS: Kidney disease,
ABSTRACT
Kidney failure, herbal drug, Kidney disease has always under concerned area since a long time specially in developing and under developing countries. It is one of the leading cause of management. death in world today. Incidence of kidney diseases leading to kidney failure is increasing day by day. The use of herbal drugs for the prevention and treatment of various diseases is now considered in thought throughout the world. A number of extracts of natural products have been reported to show protective effects against nephrotoxicity. Many herbal drugs have shown their potent nephroprotective effect due their antioxidant, diuretic, anti-inflammatory, antispasmodic properties. WHO has recently reported that traditional medicines have been existing in therapeutic practice even hundred years before the development of modern medicine. As herbs and herbal drugs have clinically proven effects like immunomodulation, adaptogenic and antimutagenic, they play a vital role in treatment of kidney diseases progressive to failure. Number of medicinal plants shows activity such as Punarnava &Varun reduces elevated blood urea & Serum Creatinine, Shigru & Sariva increase functional capacity like *Address for correspondence
prevent renal injuries, helps improve haemopoiesis, Kasni restores electrolytic Dr. Laxmi Maharana
homeostasis like sodium and Pottasium, Revand Chini detoxify the effect like significantly reduces the deposition of 2,8-dihydroxyadenine content, Shigru P.G. Dept. of Sharir Kriya, acting as anti oxident, Shirish, Amalaki, Haritaki, Punarnava act as National Institute of Ayurveda, immunomodulator, Papaya, Coriandar reducing renal hypertention, Makoi, Purnarnava reduces oxidative stress. There are various evidences which revalidate the folklore use of traditional medicines and even be helpful in the development of future medicines, treatments and treatment guidelines of kidney Mob- 09462842192 Kidney has the essential function of nonasteroidal anti-inflammatory drugs (NSAIDs). removing waste and toxins from blood and regulating Antibiotics, NSAIDs, angiotensin converting enzyme many other vital functions like maintaining fluid of the inhibitors (ACEI) and contrast agents are the major body which makes it a vital organ. When kidney damage culprit drugs contributory to kidney damage. Drug- occurs, body unable to rid of excess urine and wastes induced acute renal failure (ARF) accounted for 20% of from the body and blood electrolytes (such as potassium all ARF in an Indian study[2] of which aminoglycosides and magnesium) will all become elevated. accounted for 40% of total cases. Compared with 30 years ago, average life span Changing life style created many diseases like has increased globally which means older patients with diabetes and hypertension etc. which is a common cause more disease. They have a higher incidence of life style of Kidney disease. According to Med India incidence of disorder eg. diabetes and cardiovascular disease, take kidney failure has doubled the last 15 year and there are multiple medications, and are exposed to more over 15 million people worldwide who are alive on diagnostic and therapeutic procedures with the potential dialysis or with a functioning graft. In India there are to harm kidney function.[1] approximately 7.85 million people suffering from chronic Drug-induced kidney disease constitutes an renal failure and 90% of them are not able to afford the important cause of acute renal failure and chronic kidney cost of treatment. [3] disease in present day clinical practice. The incidence of Thus prevalence of renal diseases is increasing drug-induced nephrotoxicity has been increasing with globally. A number of therapeutic agents can adversely the ever increasing number of drugs and with easy affect the kidney resulting in acute renal failure, chronic availability of over the counter medication viz. intestinal nephritis and nephritic. AYUSHDHARA January - February 2016 Vol 3 Issue 1

AYUSHDHARA, 2016;3(1):500-508 Most drugs found to cause nephrotoxicity exert approximately 20 percent of community- and hospital toxic effects by one or more common pathogenic acquired episodes of acute renal failure. [4-6] Among older mechanisms. These include altered intraglomerular adults, the incidence of drug-induced nephrotoxicity may hemodynamics, tubular cell toxicity, inflammation, be as high as 66 percent. [7] Although renal impairment is crystal nephropathy, rhabdomyolysis, and thrombotic often reversible if the offending drug is discontinued, the microangiopathy. [9,10] condition can be costly and may require multiple interventions, including hospitalization. [8] Table 1: Various Drugs which causes Kidney disease
Drug class/drug(s)
Pathophysiologic mechanism of renal injury
Chronic interstitial nephritis Nonsteroidal anti-inflammatory drugs Acute interstitial nephritis, altered intraglomerular hemodynamics, chronic interstitial nephritis, glomerulonephritis Antidepressants/mood stabilizers
Amitriptyline, doxepin, fluoxetine
Chronic interstitial nephritis, glomerulonephritis, rhabdomyolysis Antihistamines
Diphenhydramine, doxylamine
Antimicrobials
Acyclovir
Acute interstitial nephritis, crystal nephropathy Tubular cell toxicity Tubular cell toxicity Beta lactams (penicillins, Acute interstitial nephritis, glomerulonephritis (ampicillin, Acute interstitial nephritis, crystal nephropathy (ciprofloxacin Rifampin (Rifadin) Acute interstitial nephritis Acute interstitial nephritis Tubular cell toxicity Acute interstitial nephritis, crystal nephropathy Cardiovascular agents
Angiotensin-converting enzyme
Altered intraglomerular inhibitors, angiotensin receptor blockers Clopidogrel, ticlopidine Thrombotic microangiopathy Chemotherapeutics
Carmustine (Gliadel), semustine
Chronic interstitial nephritis (investigational) Cisplatin Chronic interstitial nephritis, tubular cell toxicity Interferon-alfa (Intron A) Glomerulonephritis Methotrexate Crystal Mitomycin-C (Mutamycin) Thrombotic microangiopathy Tubular cell toxicity Diuretics
Loops, thiazides
Acute interstitial nephritis Drugs of abuse
Cocaine, heroin, ketamine,
methadone, methamphetamine Proton pump inhibitors Lansoprazole (Prevacid), Acute interstitial nephritis Omeprazole (Prilosec), Pantoprazole (Protonix) Medicinal plants have played a significant role in Ayurveda will serve as a powerful search engine various ancient traditional systems of medication. Even and most importantly, will greatly facilitate intentional, today, plants provide a cheap source of drugs for focused and safe natural products research to rediscover majority of world's population. the drug discovery process. Some important medicinal AYUSHDHARA January - February 2016 Vol 3 Issue 1

Laxmi Maharana, Om Prakash Dadhich. Role of Herbal Drug in the Prevention and Management of Kidney Disease plants can be useful in management of Renal diseases are sativum, Eruca sativa and Curcuma longa, alone and in combination were investigated against gentamicin Saunf (Trigonella foenum-graecum): Its seeds have
induced nephrotoxicity in rats. The results showed that been used by traditional herbalists for problems of gentamicin induced nephrotoxicity was ameloriated by kidney and male reproductive tract. Trigonelline (N- oral administration of aqueous infusion of Petroselinum methylnicotinic acid, N-methyl betaine) is the major sativum, Eruca sativa and Curcuma longa herbs. [18] alkaloid phytoconstituent of fenugreek seeds act by Rutin and curcumin are the polyphenolic suppression of oxidative stress in kidney and reduction compounds present in turmeric, known to have in renal cell apoptosis and fibrosis. Increased diuresis, anti-inflammatory Supplementation of rutin and curcumin restored concentrations of stone forming constituents are elevated levels of calcium and oxalate in the urine and suggested mechanism for anti-urolithiatic effects of kidney sample near to normal and showed minimum fenugreek seeds. [11] tissue damage and less number of calcium oxalate Kokilaksha (Hygrophila spinosa): The present study
deposits in kidney of animal treated with rutin and revealed that ethanolic extract of H.auriculata seeds curcumin as compared to calculi-induced animal. This significantly increased the urinary output as well as effect is mediated possibly through a lowering of urinary urinary electrolyte concentration at 500mg/kg. concentration of stone forming constituents, anti- H.auriculata seed extract treated group showed an inflammatory and antioxidant effects. [19] increase in Na+ & K+ concentrations which was more Gokshura (Tribulus terrestris)- The diuretic properties
than that of frusemide treated group indicating that it of T. terrestris are due to large quantities of nitrates and has a better saluretic activity than frusemide. [12] essential oil present in its fruits and seeds. The diuretic Male Wistar rats treated petroleum ether extract activity can also be attributed to the presence of of the heart wood of Cedrus deodara PECD (50, 100 and potassium salts in high concentration. The aqueous 200mg/kg), significantly increased the elimination of extract of T. Terrestris prepared from its fruit and leaves sodium and chlorides but they didn't show significant in rat diuretic model and strips of isolated Guinea pig elimination of the potassium when compared to vehicle was evaluated. The aqueous extract of T. terrestris, in oral treated group. Results showed that single dose dose of 5 g/kg, elicited a positive diuresis, which was administration of PECD and furosemide increased the slightly more than that of furosemide. Sodium and urine output, increase in sodium and chloride chloride concentrations in the urine were increased. The concentration. PECD 200 mg/kg showed greater diuretic increased tonicity of the smooth muscles, which was activity which is comparable to that of furosemide (10 produced by T. terrestris extract, together with its diuretic activity helped in the propulsion of stones along Kali musli (Curculigo orchioides)- The study was
the urinary tract. [20] performed to evaluate the invitro antioxidant activity of Saurabh et al. evaluated the different extracts of ethanolic root extract of Curculigo orchioides. The results T. terrestris fruits, viz. aqueous, methanolic, Kwatha-high obtained indicates the significant antioxidant activity strength, Kwatha-low strength, and Ghana powder, for compared with standard reference drug Gallic acid. [14] diuretic activity in rats. Kwatha-high strength showed Mulaka (Raphanus sativus)-The aqueous extract of
diuretic effect comparable to that of the reference Raphanus sativus showed antilithiatic activity on standard frusemide and also exhibited additional implants of calcium oxalate crystals or zinc discs in the advantage of potassium-sparing effect. The diuretic urinary bladder of rats. The effect however is unrelated action of Tribulus terrestris makes it useful as an anti- to increased diuresis or to a change of the muscarinic hypertensive agent. [21] receptor affinity of the bladder smooth musculature to Shirish (Albezzia lebbek)- Research work also depicts
cholinergic ligands. [15] the protective effect of one traditionally used polyherbal Guduchi (Tinospora cordifolia)- In a study antibacterial
formulation against the diabetes induced liver and activity of aqueous, ethanol and chloroform extracts of pancreatic damage. [22] leaves and stem of Hook. F. Thoms were tested on clinical Amalaki (Phyllanthus amblica)
isolates of urinary pathogens viz., Escherichia coli, Results show that the leaves of Ph. emblica have inhibitory activity on PMNs and platelets, which confirm Pseudomonas aeruginosa by agar well diffusion method. the anti-inflammatory and antipyretic properties of this Ethanol extract of leaf showed greater inhibitory action plant as suggested by its use in traditional medicine. [23] than other tested extracts. [16] It has been claimed to The present study suggests that PE extract possess antidepressant, antistress, learning and memory administration pretreatment for five days in dose 250 enhancing, antioxidant & diuretic effect. Diuretic effects and 500 mg/kg/day before the induction of CI-AKI exerts may also reduce stone development when total fluid significant renoprotective effects in a rat model of CI-AKI. intake and output increased, and such effects have been These finding indicate that PE extract could represent a attributed to several herbal preparations. [17] novel and effective preventive approach for CI-AKI as a Haridra (Curcuma longa)- The nephroprotective and
result of its antioxidant capacity to preserve renal diuretic effects of three medicinal herbs Petroselinum function and directly protect renal tissues. Investigation AYUSHDHARA January - February 2016 Vol 3 Issue 1

AYUSHDHARA, 2016;3(1):500-508 with additional experimental studies and clinical trials is peroxidation, and increased levels of superoxide required to confirm to the advantage of PE extract to dismutase and catalase and concluded that urolithiatic prevent the CI-AKI. [24] effect is due to antioxidant activity. [32] Antioxidant effect of PE extract could decrease Barley act as antioxidant and anti-inflammatory play an MDA in both plasma and renal tissues. Moreover, PE important role in the protection from incidence of extract preserved plasma TAC and renal tissues TAC, chronic renal failure. On the other hand some beverages SOD and CAT activities. These effects correlated with the made from barley have been used in Egypt as Folk attenuation of histopathological injury from contrast medicine to alleviate kidney dysfunction. Phytate, β- media administration. The dose dependent effect of PE glucan, tocopherols and tocotrienols were reported to extract started at dose 250 mg/kg/d and had the present in barley seeds. [33] additional effect at dose 500 mg/kg/d similar to the Orange (Citrus sinensis)- In a study Administration of
antioxidant effect of vitamin E in the experimental the ethanol extract showed significant decreases in study[25] and clinical trial. [26] hematologic parameters and increases in animal body Haritaki (Terminalia chebula)- In a study in the liver
weight, liver, renal, lipid and glycemic parameters as well and kidney of aged animals, enhanced oxidative stress as vascular and inflammatory changes in liver and was accompanied by compromised antioxidant defences. kidney, at high doses. The aqueous extract acted like an Administration of aqueous extract of T. cheubla immune stimulator, with strong antioxidant activity. [34] effectively modulated oxidative stress and enhanced Pashanbheda (Aerva lanta)- The ethanolic extract of
antioxidant status in the liver and kidney of aged rats. the entire plant of Aerva lanata was studied for its The results of the present study demonstrate that nephroprotective activity in cisplatin and gentamicin aqueous extract of T. cheubla inhibits the development of induced acute renal injury in albino rats. The results age-induced damages by protecting against oxidative suggest that the ethanolic extract of Aerva lanata possesses marked nephroprotective activity with The extract of T. chebula has been reported to minimal toxicity and could offer a promising role in the possess uraemic toxin decreasing action in rats. It lowers treatment of acute renal failure caused by nephrotoxins the serum concentration of urea nitrogen, creatinine, like cisplatin and gentamicin. [35] methyl guanidine and guandinio succenic acid Aswagandha (Withania somnifera)- Ashwagandha root
significantly. [28] possess nephroprotective effect. In an experimental Punarnava (Boerhaavia diffusa)-It is used in various
study it was observed that, the mean serum urea, renal disorders including calcium oxalate urolithiasis. creatinine levels were significantly (p<0.001) higher in Studies reveal that, the antioxidant activity significantly gentamicin treated control group in comparison to those protects against hyperoxaluric oxidative stress and renal of baseline control. Again, these levels were significantly cell injury in urolithiasis. [29] Apart from this, Punarnava (p<0.01) lower in Ashwagandha pretreated and is proved to be nephroprotective agent. In an gentamicin treated group (experimental group) when experimental study histopathological changes showed compared to those of gentamicin treated group (control). that acetaminophen caused significant structural damages to kidneys like tubular necrosis, degeneration Shigru (Moringa oleifera)- Methanolic extract of root
of epithelial cells, glomerular damage and congestion was found to contain some alkaloids (total alkaloids which was reversed with B. diffusa. [30] 0.2%). Effects of multiple weekly (35, 46, 70 mg/kg) and Varuna (Crataeva nurvala)- Stem bark of varuna tree
daily therapeutic (3, 5, 4, 6, 7.0 mg/kg) ip doses of the contains a major component known as lupeol. The crude extract (CE) on liver and kidney functions and cytoprotective action of lupeol isolated from C. nuvala hematological parameters in mice were studied. [37] stem bark against free radical toxicity has been Manjjistha (Rubia cordifolia)-
investigated in experimental urolithiasis. Lupeol In a study the hydro-alcoholic extract of Rubia adminstration induced a remarkable decrease in kidney cordifolia was investigated against Cisplatin induced oxalate level and also was effective in counteracting the nephrotoxicity in Swiss albino mice. Cisplatin at a dose of free radical toxicity by bringing about a significant 12 mg/kg body wt was administered intraperitoneally decrease in peroxidative levels and an increase in while another set of animals were given hydro-alcoholic antioxidant status. These observations highlight the extract of Rubia cordifolia at different doses along with antioxidant property of lupeol and its cytoprotection cisplatin treatment. The extract significantly decreased against free radical toxicity. [31] the cisplatin induced nephrotoxicity. The study Barley (Hordeum vulgare)- It contain flavonoid i.e.-
concluded the nephroprotective role of Hydro-alcoholic saponarin which on hydrolysis gives equilibrium mixture extracts of Rubia cordifolia. [38] of saponaretin & vitexin, which is responsible for its Brihat Gokshura (Pedalium murex)- Nephrotoxicity
antioxidant effect. Ethanolic extract of H. vulgare seeds was induced in Wistar rats by intraperitoneal (EHV) significantly reduced the urinary excretion of the administration of Cisplatin 5mg/kg.Effect of concurrent calcium, phosphate, uric acid, magnesium, urea, and administration of Pedalium murex ethanolic extract at a oxalate and increased the excretion of citrate compared dose of 250 mg/kg given by oral route was determined to EG control. It was also observed that the treatment using serum creatinine and blood urea and change in with EHV produced significant decrease in lipid
AYUSHDHARA January - February 2016 Vol 3 Issue 1

Laxmi Maharana, Om Prakash Dadhich. Role of Herbal Drug in the Prevention and Management of Kidney Disease body weight as indicators of kidney damage. Cystone was Corn silk (Stigma maydis) –It contain fatty acid 2.5%,
used as standard drug. The study showed that the volatile oil 0.12%, gum 3.8%, resin 2.7%, saponin 3.18%, ethanolic extract of dried fruits of Pedalium murex has an alkaloids 0.05%, flavonoids, allantoin and moderate excellent nephroprotective activity as compared to amount of zinc, potassium, calcium, phosphorus. The cystone. [39] rational behind its use for the treatment of kidney stones Sahadevi (Vernonia cinerea)- The alcoholic extracts of
is that it reduces irritation, increases urine secretion & in aerial parts of Vernonia cinerea has been examined for its addition, it possesses excellent antioxidant capacity. It effect on cisplatin induced nephrotoxicity at a dose of was found that the alcoholic extract antiurolithiatic 6mg/kg, i.p. in albino rats. The alcoholic extract showed activity in dissolution of regenerated calcium oxalate pronounced curative activity and the ethyl acetate extract has exhibited good prophylactic activity and Revand Chini (Rheum emodi)- The renal effects of
petroleum ether extract showed moderate protection for water-soluble (W-S) and water-insoluble (W-INS) both curative and prophylactic models against cisplatin- portions of the alcoholic extract of R. emodi were induced toxicity. [40] investigated on cadmium chloride, mercuric chloride, Shunti (Zingiber officinale)- Nephrotoxicity was
gentamicin-induced induced by i.p. administration of gentamicin 100 nephrotoxicity in rats and normal rats by monitoring the mg/kg/day for eight days in wistar rats. Effect of levels of urea nitrogen and creatinine in serum. The concurrent administration of ethyl acetate extract and present investigations provide evidences that W-S fresh juice extract of Zingiber officinale at a dose of 200 fraction has nephroprotective effect on all the proximal mg/kg/day given by oral route. Gentamicin-induced tubule segments (S1, S2 and S3) possibly through glomerular congestion, peritubular and blood vessel antioxidant action of the tannins present in the fraction. congestion, epithelial desquamation, accumulation of W-INS also improved the renal function by protecting S2 inflammatory cells and necrosis of the kidney cells were segment of proximal tubule nephrotoxicity induced by found to be reduced in the groups receiving the ethyl metals viz cadmium chloride and mercuric chloride in rat acetate and dried fresh juice extract of Zingiber ofiicinale models, however, this fraction has been found to enhance along with gentamicin. The study concluded that both gentamicin nephrotoxicity. [46] extracts possess significant nephroprotective activity. [41] Papaya (Carica papaya Linn.): Carica papaya Linn.) has
Ginger has been reported to possess a potent nephroprotective effect on CCl4 renal injured rats, an anti-oxidant activity in vitro which reduces the oxidative effect which could be mediated by any of the stress in the body. Administration of its ethanolic extract phytocomponents present in it via either antioxidant to ethylene glycol rats prevented super saturation of and/or free radical scavenging mechanism. [47] calcium oxalate and thus decreased their deposition in Crude ethanol extract was prepared from the renal tubules due to active compound present in the unripened fruit of Carica papaya treated with extract. The mean arterial blood pressure (MAP) and the heart Makoy (Solanum nigrum)- The extract of S.nigrum
rate were measured in all assigned group and control. nephroprotective extract produced about 28% more depression of MAP Nephrotoxicity was induced in Wistar rats by than hydrallazine in the hypertensive groups. In vitro intraperitoneal administration of gentamicin 100 study suggested that the fruit juice of C. papaya probably mg/kg/day for eight days. Effect of concurrent contains antihypertensive agent(s) which exhibits mainly administration of fresh juice extract of S. nigrum at a alpha-adrenoceptor activity. [48] dose of 100 mg/kg/day given by oral route was determined using serum creatinine, AST, ALT, blood polyphenolic extract of C. Intybus at a dose of 500 mg/kg urea, ALP, ACP, reduced glutathione, catalase, glutathione b.w. partially protected the ion homeostasis altered by peroxidase and protein as indicators of kidney damage. Cisplatin administration. Increased doses and time The fresh juice extract of S. nigrum significantly duration of herbal polyphenolic extract could function to protected rat kidneys from gentamicin-induced reverse the toxic effect. [49] nephrotoxicity by normalizing the alterations in Dhanyaka (Coriandum sativum): coriander has been
biochemical parameters. [43] reported to exhibit antioxidant properties. [50] Sariva (Hemidescus indicus linn)- The treatment with
Vasodilatory effects of coriander are well-established. H. indicus helped in the management of renal Indeed, intravenous application of aqueous methanolic impairment, which was induced by gentamicin in rats. extract of dried, ground coriander seeds (1–30 mg/ml) This is evident from the results obtained for various produced a dose-dependent fall in SBP, DBP, and mean kidney function tests for gentamicin, along with the arterial blood pressure (MABP) in normotensive results from the plant treated group, and is in Sprague-Dawley rats by 40.84 ± 6.34%. The same report comparison with the results found for the gentamicin also showed that coriander fruit extracts produced dose- recovery group. A histological examination of kidneys dependent relaxation of pre-constricted (phenylephrine also supports the findings from haematological and potassium chloride) rabbit aortas, and this response evaluations. The plant shows promise as an adjunct was atropine and calcium-channel dependent. [51] therapy alongside aminoglycosides as it reduces Makoy (Solanum nigrum): The extract of Solnum
nephrotoxicity caused by aminoglycosides. [44] nigrum possesses significant nephroprotective activity. AYUSHDHARA January - February 2016 Vol 3 Issue 1

AYUSHDHARA, 2016;3(1):500-508 Nephrotoxicity was induced in Wistar rats by elevated blood urea and serum creatinine and intraperitoneal administration of gentamicin 100 normalized the histopathological changes in the cisplatin mg/kg/day for eight days. Effect of concurrent model. In the gentamicin model the rats in the preventive administration of fresh juice extract of Solanum regimen also showed good response to the ethanol nigrum at a dose of 100 mg/kg/day given by oral route extract at 300 mg/kg. The results suggest that the was determined using serum creatinine, AST, ALT, blood ethanolic extract of Aerva lanata possesses marked urea, ALP, ACP, reduced glutathione, catalase, glutathione nephroprotective activity with minimal toxicity and peroxidase and protein as indicators of kidney damage. could offer a promising role in the treatment of acute The fresh juice extract of Solanum nigrum significantly renal failure caused by nephro-toxins like cisplatin and protected rat kidneys from gentamicin-induced gentamicin. [54] nephrotoxicity by normalizing the alterations in Badriphal (Hippophae rhamnoides) One pilot study
biochemical parameters. [52] showed beneficial effect of the herbal preparation Ashwagandha (Withania somnifera)- Withania extract
Hippophae rhamnoides as add on treatment in idiopathic along with the antigen (SRBC) produced an enhancement nephrotic syndrome. Patients of NS were randomly in the circulating antibody titre and the number of divided into two groups A and B, each group comprising plaque forming cells (PFC) in the spleen. Maximum of 28 patients. Both groups were treated by standard number of PFC (985 PFC/106 spleen cells) was obtained treatment protocol for specific histological type. In group on the fourth day. Withania extract inhibited delayed B standard treatment plus Hippophae rhamnoides 350 type hypersentivity reaction in mice (Mantoux test). mg twice a day was given for 12 weeks as add on Administration of Withania extract also showed an treatment. Patients were followed up every two weeks enhancement in phagocytic activity of peritoneal initially and then once in four weeks up to 12 weeks. At macrophages (76.5 pigmented cells/200) when compared the end of 3 month patients showed improvement in the to control (31.5/200 cells) in mice. These results confirm symptoms of edema, anorexia, oliguria in the herbal the immunomodulatory activity of W. somnifera extract. group. The urinary estimation of protein showed significant decrease in Group B with elevation of S. Pashanbheda (Aerva lanta)- The ethanolic extract of
albumin levels. The inflammatory cytokines had showed the entire plant of Aerva lanata was studied for its significant decrease at the end of 3 month. The study nephroprotective activity in cisplatin and gentamicin concluded the beneficial role of Hippophae rhamnoides induced acute renal injury in albino rats of either sex. In as add on therapy in difficult idiopathic nephrotic the curative regimen, the extract at dose levels of 75, 150 syndrome patients. [55] and 300 mg/kg showed dose-dependent reduction in the Table 2: Various action of drugs in Prevention and Management of Kidney Diseases
Mechanism of Action
Herbal Drug
1. Diuretic activity
Saunf (Trigonellafoenum-graecum)11 Kokilaksha (Hygrophilaspinosa)12 Devadar (Cedrusdeodara)13 Mulak (Raphanussativus)15 Guduchi (Tinospora cordifolia)17 Haridra (Curcuma longa)18 Gokshura(Tribulus terrestris)20 21 2. Antioxidant activity
Kali musli (Curculigoorchioides)14 Saunf (Trigonellafoenum-graecum)11 shirish (Albezzia lebbek)22 Amalaki (Phyllanthus amblica)25 26 Haritaki (Terminalia chebula)27 Punarnava (Boerhaavia diffusa)28 Varuna (Crataeva nurvala)31 Barley (Hordeum vulgare)32 Orange (Citrus sinensis)34 Haridra (Curcuma longa)19 Shunti (Zingiber officinale)42 Corn silk (Stigma maydis)45 Papaya (Carica papaya Linn.)47 Dhanyaka (Coriandum sativum)50 3. Nephroprotective against drug
Amalaki (Phyllanthus amblica)24 induced renal injury (Prophylactic / Punarnava (Boerhaavia diffusa)30
Management)
Varuna (Crataeva nurvala)31 Pashanbheda (Aerva lanta)35 Ashwagandha (Withania somnifera)36 Haridra (Curcuma longa)18 AYUSHDHARA January - February 2016 Vol 3 Issue 1
Laxmi Maharana, Om Prakash Dadhich. Role of Herbal Drug in the Prevention and Management of Kidney Disease Shigru (Moringa Oleifera )37 Manjjistha (Rubia cordifolia)38 Brihat Gokshura (Pedalium murex)39 Sahadevi (Vernonia cinerea)40 Shunti (Zingiber officinale)41 Makoy (Solanum nigrum) 43 Sariva (Hemidescus indicus)44 Revand Chini (Rheum emodi) 46 Kasni (Cichorium intybus)49 Pashanbheda (Aerva lanta)54 Shigru (Moringa Oleifera) 5. Atiinflammatory
Haridra (Curcuma longa)19 Amalaki (Phyllanthus amblica)23 Barley (Hordeum vulgare)33 Badriphal (Hippophae rhamnoides)55 6. Immunomodulator
Ashwagandha (Withania somnifera)53 All nephroprotective and antioxidant, antioxidant and anti-inflammatory drugs can be included in this group. 7. Cytoprotective
Varuna (Crataeva nurvala)31 8. reduces elevated blood urea &
Punarnava (Boeharavia diffusa)29 Serum Creatinine
Haritaki (Terminalia chebula)28 Makoy (Solanum nigrum)52 9. reducing renal hypertention
Gokshura (Tribulus terrestris)21 Papaya (Carica papaya)48 Dhanyaka (Coriandum sativum)51 10. reduces oxidative stress
Punarnava (Boeharavia diffusa)29 Guduchi (Tinospora cordifolia( 17 Haridra (Curcuma longa)19 Shunti (Zingiber officinale)42 11. Antimicrobial
Guduchi (Tinospora cordifolia)17
CONCLUSION

In conclusion, From this study, it is clear that the 5. Nash K, Hafeez A, Hou S. Hospital-acquired renal medicinal plants play a prominent role against various insufficiency. Am J Kidney Dis. 2002;39(5):930-936. diseases. A variety of medicinal plants and plants 6. Bellomo R. The epidemiology of acute renal failure: extracts have been reported for its significant role in 1975 versus 2005. Curr Opin Crit Care. 2006; 12(6): kidney disease. The activity of these drug is probably due to the nephroprotective, cytoprotective, immuno- 7. Kohli HS, Bhaskaran MC, Muthukumar T, et al. modulator, antioxidant, anti-inflammatory, reduces Treatment-related acute renal failure in the elderly: oxidative stress, renal hypertention and various toxin a hospital-based prospective study. Nephrol Dial present in blood like urea, creatinine etc so have good Transplant. 2000;15(2):212-217. potentials for use in kidney damage. Thus India traditional medicine very broad range of drugs which can 8. Gandhi TK, Burstin HR, Cook EF, et al. Drug be used in kidney diseases by their diversity to treat the complications in outpatients. J Gen Intern Med. disease and to rejuvenate the normal function of kidney. 2000;15(3):149-154. So it is recommended that furher studies should be done 9. Schetz M, Dasta J, Goldstein S, Golper T. Drug- to know the various aspect and mechanism of drugs. induced acute kidney injury. Curr Opin Crit Care. REFERENCES
2005;11(6):555-565. 10. Zager RA. Pathogenetic mechanisms in nephrotoxic Hoste EA, Kellum JA. Acute kidney injury: epidemiology and diagnostic criteria. Curr Opin Crit acute renal failure. Semin Nephrol.1997;1(1):3-14. Care. 2006;12(6):531-537. 11. Kapase CU, Bodhankar SL, Mohan V and Thakurdesai PA,(2013), Therapeutic effects of Jha V, Chugh KS. Drug induced renal disease. J Assoc Physicians India 1995;43:407-21. experimental urolithiasis in rats. Journal of Applied Pharmaceutical Science, 3(09), 029-035. ccessed on 12 May 2016 12. Preethi gp, acute diuretic activity of alcoholic 4. Kaufman J, Dhakal M, Patel B, Hamburger R. extracts of hygrophila auriculata seeds in normal Community- acquired acute renal failure. Am J wistar albino rats, International Journal of Pharma Kidney Dis. 1991;17(2):191-198. and Bio Sciences Vol 3/Issue 1/Jan – Mar 2012 AYUSHDHARA January - February 2016 Vol 3 Issue 1
AYUSHDHARA, 2016;3(1):500-508 13. Ramesh C., Nandakumar Krishnadas, Rajesh 27. Mahesh R Effect of Terminalia chebula aqueous Radhakrishnan, Srinath Rangappa, Gollapalle extract on oxidative stress and antioxidant status in Lakshminarayana Shastry Viswanatha, Rajesh D, the liver and kidney of young and aged rats. Cell MurugananthanGopal, and Sahil Talwa. Anti- Biochem Funct. 2009 Aug;27(6):358-63 Urolithiatic Activity of Heart Wood Extract of 28. Yokozawa T, Fujioka K, Oura H, Tanaka T, Nonaka G, Cedrus deodara in Rats. Journal of Complementary Nishioka I. Confirmation that tannin containing and Integrative Medicine, Vol. 7 [2010], Iss. 1, Art. crude drugs have a ureamic toxin decreasing action. Phytotherapy Research. 1995; 9 (1):1-5. 14. Ratnam et al evaluation of invitro antioxidant 29. Surendra K. Pareta, Kartik C. Patraa, Papiya M. activity of ethanolic root extract of curculigo Mazumderb & Dinakar Sasmal. Aqueous extract of orchioides IJRPC 2013, 3(2) pg 364-369. Boerhaavia diffusa root ameliorates ethylene 15. Selvam R, Kalaiselvi P, Govindaraj A, Balamurugan glycol-induced hyperoxaluric oxidative stress and V, and Satish Kumar AS; Effect of Aerva lanata leaf renal injury in rat kidney. Pharmaceutical Biology. extract and vediuppu chunnam on the urinary risk Volume 49, Issue 12, 2011,pages 1224-1233. factors of calcium oxalate urolithiasis during 30. Surendra K. Pareta, Kartik C.Patra, Ranjeet experimental hyperoxaluria. Pharmacol. Res. 2001; Harwansh, Manoj Kumar, Kedar Prasad Meena. Protective Effects of Boerhaavia Diffusa Against 16. Shanthi AV, Nelson R. Anitbacterial activity of Acetaminophen Induced nephrotoxicity in Rats. Tinospora cordifolia (Willd) Hook.F.Thoms on Pharmacologyonline, 2011, 2: 698-706. urinary tract pathogens. International journal of 31. Baskar R, Meenalakshmi Malini & Varalakshmi P, Effect of lupeol isolated from Crataeva nurvala stem bark against free radical-induced toxicity in 17. Kumar G P, Mittal A and Kumar R, (2011), experimental urolithiasis, Fitoterapia, 67 (1996) Antiurolithiatic Potential. JPBMS, 9 (14), 1-5. 32. Shah JG, Patel BG, Patel SB and Patel RK, (2012), 18. Elgazar A, Alaa O, Abo Raya. Nephroprotective and Antiurolithiatic and antioxidant activity of Diuretic Effects of Three Medicinal Herbs Against Hordeumvulgare seeds on ethylene glycol-induced Gentamicin-Induced Nephrotoxicity in Male Rats. urolithiasis in rats. Indian J Pharmacol, 44(6), 672- Pakistan Journal Of Nutrition 2013;12(8):715-722. 19. G Jaydip, P Anil, D Chinmay and K Bhanudas, 33. R. A. Moreau, P. Bregitzer, K. Liu, and K. B. Hicks, (2010), Inhibitory effect of rutin and curcumin on "Compositional equivalence of barleys differing experimentally-induced calcium oxalate urolithiasis only in low- and normal-phytate levels," J Agric in rats. Pharmacognosy Res, 2(6), 388–392. Food Chem., 60(26), 6493-8, 2012. 20. Al-Ali M, Wahbi S, Twaij H, Al-Badr A. Tribulus 34. Tarkang, P. A.; Agbor, G. A Journal Der Pharmacia terrestris: Preliminary study of its diuretic and Lettre 2012 Vol. 4 No. 5 pp. 1619-1629. contractile effects and comparison with Zea mays. J 35. Shirwaikar A, Issac D, Malini S. Effect of Aerva Ethnopharmacol. 2003;85:257–60. lanata on cisplatin and gentamicin model of acute 21. Chhatre S, Nesari T, Somani G, Kenjale R, Sathaye S. renal failure. Journal of Ethnopharmacology 2004; Comparative Evaluation of Diuretic Activity of Different Extracts of Tribulus terrestris Fruits in 36. Sadia Choudhury Shimmi, Nasim Jahan, Nayma Experimental Animals. Int J Res Phytochem Sultana. Effect of Ashwagandha (Withania Somnifera) Root Extract Against Gentamicin 22. Szkudelski T: The mechanism of alloxan and Induced Changes of Serum Urea and Creatinine streptozotocin action in B cells of the rat pancreas. Levels in Rats. J Bangladesh Soc Physiol. 2011 Physiol Res. 2001, 50: 536-546. December; 6(2): 84-89. 23. Arja Ihantola-Vormisto Anti-Inflammatory Activity 37. Mazumdar UK, Gupta M, Chakrabarti S, Pal D. of Extracts from Leaves of Phyllanthus emblica Evaluation of methanolic extract of Moringa oleifera Planta Med 1997; 63(6): 518-524. Lam. Root treated mice. Indian Journal of 24. Tasanarong et al. BMC Complementary and Experimental Biology.1999; 37(6):612-614. Alternative Medicine 2014, 14:138. 38. Joy J, Nair CK. Amelioration of cisplatin induced 25. Kongkham S, Sriwong S, Tasanarong A. Protective nephrotoxicity in Swiss albino mice by Rubia effect of alpha tocopherol on contrast-induced cordifolia extract. Journal of Cancer Research and nephropathy in rats. Nefrologia. 2013;33(1):116– 39. Shelke TT, Kothari R, Adkar P, Bhaskar VH, Juvale 26. Tasanarong A, Piyayotai D, Thitiarchakul S. K.C, Kamble BB, Oswal RJ. Nephroprotective activity Protection of radiocontrast induced nephropathy of ethanolic extract of dried fruits of Pedalium by vitamin E (alpha tocopherol): a randomized murex Linn. Journal of Cell and Tissue Research, controlled pilot study. J Med Assoc Thai. 2009 2009; 9(1):1687-1690. Oct;92(10):1273-81. AYUSHDHARA January - February 2016 Vol 3 Issue 1
Laxmi Maharana, Om Prakash Dadhich. Role of Herbal Drug in the Prevention and Management of Kidney Disease 40. Sreedevi A, Bharathi K, Prasad K.V.S.R.G. Effect of 48. A. E. Eno Blood Pressure Depression by the Fruit Vernonia cinere aaerial parts against Cisplatin- Juice of Carica Papaya (L.) in Renal and DOCA- induced nephrotoxicity in rats. Pharmacologyonline induced Hypertension in the Rat Phytother. Res. 14, 235–239 (2000). 41. Lakshmi BVS, Sudhakar M. Protective Effect of 49. Shafaq Noori and Tabassum Mahboob Role of Gentamicin-Induced electrolytes disturbances and Na+ -K + -ATPase in Nephrotoxicity in Rats. International Journal of cisplatin – induced renal toxicity and effects of Pharmacology 2010;6(1):58-62. ethanolic extract of Cichorium intybus Pak. J. 42. Lakshmi BVS and Divya V, (2014), Antiurolithiatic Pharm. Sci., Vol.25, No.4, October 2012, pp.857-862. and antioxidant activity of Zingiber officinale 50. Sreelatha S., Padma P. R., Umadevi M. (2009). rhizomes on ethylene glycol-induced urolithiasis in Protective effects of Coriandrum sativum extracts rats. International journal of advances in pharmacy on carbon tetrachloride-induced hepatotoxicity in medicine and bioallied sciences, 2(3),148-153. rats. Food Chem. Toxicol. 47, 702–708. 43. Priya, N.; Venkatalakshmi, P. Nephroprotective 51. Jabeen Q., Bashir S., Lyoussi B., Gilani A. H. (2009). effect of Solanum nigrum L. on gentamicin induced Coriander fruit exhibits gut modulatory, blood toxicity in male albino rats. Asian Journal of Bio pressure lowering and diuretic activities. J. Science 2011 Vol. 6 No. 2 pp. 169-172. Ethnopharmacol. 122, 123–130. 44. Mangala S, Patel P, Menon NS, Sane TR. 52. Priya, N.; Venkatalakshmi, P. Nephroprotective Renoprotective effect of Hemidesmus indicus, a effect of Solanum nigrum L. on gentamicin induced gentamicin-induced toxicity in male albino rats. Asian Journal of Bio renaltoxicity. Nephrology. 2004; 9 (3):142-152. Science 2011 Vol. 6 No. 2 pp. 169-172. 45. Rathod VD, Fitwe P, Sarnaik D and Kshirsagar SN, 53. Leemol Davis, Girija Kuttan. Immunomodulatory (2013), In-vitro Anti-Urolithiatic Activity of Corn activity of Withania somnifera. Journal of Ethno Silk of Zea Mays. Int. J. Pharm. Sci. Rev. Res., pharmacology 2000; 71(1, Suppl 2): 193-200. 54. Shirwaikar A, Issac D, Malini S. Effect of Aerva 46. M.M. Azhar Alama, Kalim Javedb, Effect of Rheum lanata on cisplatin and gentamicin model of acute emodi (Revand Hindi) on renal functions in rats renal failure. Journal of Ethno pharmacology 2004; Journal of Ethnopharmacology Volume 96, Issues 1– 2, 4 January 2005, Pages 121–125. 55. Singh RG, Singh P, Singh PK, Usha Agrawal A, 47. JA Olagunju Nephroprotective activities of the Upadhyay BN, Soni A. Immunomodulating and aqueous seed extract of Carica papaya Linn. in Antiproteinuric Effect of Hippophae rhamnoides carbon tetrachloride induced renal injured Wistar (Badriphal) in Idiopathic Nephrotic Syndrome. rats: a dose- and time-dependent study Biology and Journal of the Association of Physicians of India Medicine, Vol. 1 (1): 11-19, 2009. 2013; 61(6): 397-399. Cite this article as:
Laxmi Maharana, Om Prakash Dadhich. Review on Role of Herbal Drug in the Prevention and
Management of Kidney Disease. AYUSHDHARA, 2016;3(1):500-508.
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