Use of Herbal Supplements in Chronic Kidney Disease

As a chronic kidney disease (CKD) patient, you may have considered the use of herbal products to assist you with various health concerns. This fact sheet will give you some information to enable you to make decisions regarding your use of herbs.

Use of herbal supplements may be unsafe for CKD patients, since your body is not able to clear waste products like a healthy person. There are some facts about herbs that every CKD patient should know:

• Very few herbs have been studied in CKD patients. What may be safe for healthy persons may not be safe for someone with CKD, and in fact, could be dangerous. Therefore, you need to be very cautious about your use of these products.
• The government does not regulate herbal supplements, so the exact content of these products is unknown.
• Without regulation, there are no requirements for testing, so the purity, safety and effectiveness of the products are unknown.
• Herbal preparations are subject to contamination (may contain toxic heavy metals such as lead or mercury).
• Products may contain minerals harmful to CKD patients, for example: potassium.

Some herbs that may serve as diuretics may also cause “kidney irritation” or damage. These include bucha leaves and juniper berries. Uva Ursi and parsley capsules may have negative side effects as well.

Many herbs can interact with prescription drugs. A few examples are St. Johns Wort, echinacea, ginkgo, garlic, ginseng, ginger, and blue cohosh. Transplant patients are especially at risk, as any interaction between herbs and medications could potentially put them at risk for rejection or losing the kidney. It is important to ask your doctor and/or pharmacist about any herbs or medicines you want to take to avoid potential problems.

Herbs that may be toxic to the kidneys
Artemisia absinthium (wormwood plant)	Periwinkle
Autumn crocus	Sassafras
Chuifong tuokuwan (Black Pearl)	Tung shueh
Horse chestnut	Vandelia cordifolia

Herbs that may be harmful in chronic kidney disease
Alfalfa	Buckthorn	Ginger	Nettle	Vervain
Aloe	Capsicum	Ginseng	Noni juice
Bayberry	Cascara	Horsetail	Panax
Blue Cohosh	Coltsfoot	Licorice	Rhubarb
Broom	Dandelion	Mate	Senna

Herbs known to be unsafe for all people
Chapparal	Pennyroyal
Comfrey	Pokeroot
Ephedra (Ma Huang)	Sassafras
Lobelia	Senna
Mandrake	Yohimbe

These lists are not necessarily complete. More information regarding the use of herbs will become available over time. You are encouraged to proceed with caution with all herbal preparations and use them only under the direction of your medical team.

With all of these cautions, perhaps you are wondering if use of any herbs is a good idea. The use of common herbs, in normal amounts, when cooking is just fine and typically recommended to enhance the flavor of foods on a low-sodium diet.

So, before you take any herbal supplement, we recommend:

• Checking with your doctor, dietitian, pharmacist and/or product manufacturer regarding safety, dosage, duration of use, interactions with prescription drugs, etc.
• Use only standardized herbal extracts made by reputable companies.
• Never take more than the recommended dosage, or longer than recommended.
• Do not use herbal remedies for serious illness.
• Do not use herbs if considering pregnancy.

Remember … natural does not mean safe, especially for CKD patients. Be smart and ask questions before using any herbal products.