Herbal Medicines Can Also Harm the Kidneys—Usage Requires Caution
After media reports highlighted that certain patent medicines containing Aristolochia manshuriensis (Guanmutong) could harm the kidneys, public concern grew. Recently, a practicing pharmacist in Shenzhen, unwilling to disclose their name, warned patients that some decoctions might cause renal damage. Long-term users of herbal decoctions must take this potential side effect seriously.
The kidneys are the body’s main detoxification organs and are prone to displaying adverse drug reactions. In December of last year, the National Adverse Drug Reaction Monitoring Center released a list of nine drugs—both Western and Chinese patent medicines—reporting adverse reactions, including those containing Guanmutong.
Besides Guanmutong, other Chinese herbs may also cause renal damage. Reported cases in China include Tripterygium wilfordii (Leigongteng), Pharbitis nil (Qian Niu Zi), Xanthium sibiricum (Cang Er Zi), Papaver somniferum (Ying Su Ke), Aconitum carmichaelii (Sheng Cao Wu), and Semen Jujubae (Shi Jun Zi). Among these, Leigongteng causes the most severe renal damage, followed by Guanmutong. The reason Guanmutong harms the kidneys is due to its content of nephrotoxic aristolochic acid. Similarly, Aristolochia species such as Aristolochia debilis (Qingmu Xiang) and Stephania tetrandra (Guang Fang Ji), which have antihypertensive effects, also contain aristolochic acid.
Whether a single herb causes renal damage depends primarily on its chemical components. If a herb contains ingredients potentially harmful to the kidneys, long-term or excessive use will inevitably affect kidney health. A report analyzing herb-induced renal damage indicates that nearly 90% of cases result from overdose.
This pharmacist emphasized that processing methods, herb compatibility, decoction techniques, and usage protocols may mitigate some herbs’ nephrotoxicity. Patients requiring long-term medication should carefully read the instructions and consult their prescribing physician about possible toxic side effects. Elderly people, children, and pregnant women should use herbal medicines with caution, avoiding high doses and prolonged courses, and remain vigilant for any adverse reactions after taking medication.