Nephrotoxicity and Herbal Interventions: Mechanistic Insights and Safety Concerns

Bwanbale Geoffrey David

Faculty of Pharmacy Kampala International University Uganda

ABSTRACT

Nephrotoxicity, defined as structural and functional impairment of the kidneys due to chemical, biological, or metabolic insults, is a significant contributor to global morbidity and mortality. It arises from diverse causes including pharmaceutical agents, heavy metals, environmental toxins, infectious diseases, and metabolic conditions such as diabetes and hypertension. Pathophysiological mechanisms involve oxidative stress, mitochondrial dysfunction, inflammation, dysregulation of renal hemodynamics, and apoptosis/necrosis of tubular cells. Herbal medicines have been investigated both as protective interventions and, paradoxically, as causative agents of nephrotoxicity. Numerous phytochemicals-such as polyphenols, flavonoids, alkaloids, terpenoids, and saponins-exhibit antioxidative, anti-inflammatory, and cytoprotective activities, which may counter renal injury by modulating signaling pathways (Nrf2, NF-κB, TGF-β/Smad). Prominent candidates include curcumin, resveratrol, silymarin, quercetin, and berberine, as well as complex formulations from Ayurvedic, Chinese, and African traditional medicine. However, nephrotoxic risks arise from intrinsic phytochemical toxicity (e.g., aristolochic acids), adulteration with heavy metals, contamination, or herb-drug interactions. The duality of herbal remedies as potential nephroprotectants and nephrotoxins demands rigorous mechanistic research, standardized preparations, and long-term clinical trials. This review synthesizes current evidence on nephrotoxicity mechanisms, the protective role of herbal interventions, and the safety concerns critical to clinical translation.

Keywords: nephrotoxicity, herbal medicine, oxidative stress, renal protection, safety

 

CITE AS: Bwanbale Geoffrey David (2026). Nephrotoxicity and Herbal Interventions: Mechanistic Insights and Safety Concerns. International Digital Organization for Scientific Research                       

IDOSR JOURNAL OF SCIENCE AND TECHNOLOGY 12(1):56-60. https://doi.org/10.59298/IDOSR/JST/26/113.5660