Nephrotoxicity of herbal products

The kidney is one of the major routes of excretion of drugs and metabolites, and given its high blood flow and metabolic activity, it is highly susceptible to injury by toxic drugs and herbs. In addition, high concentrations of toxic metabolites are in close contact with tubular cells due to urine concentration, especially during a state of fluid deprivation. The incidence of nephrotoxicity related to alternative medicines is not known. However, regarding the large number of individuals consuming herbs as alternative remedies and regarding the lack of control of over-the-counter products, clinicians should consider alternative medicine consumption in the differential diagnosis of unexplained kidney injury.