Herbal Supplements and Your Kidneys

By Judy Kirk MS, RDN, CSR, CDN
Clinical Nutrition Specialist at Rochester General Hospital, Rochester, NY
Member NKF
Registered Dietitian for over 30 years, working in CKD for 10 years

The herbal supplement market is a multi-million dollar business. Many times we hear from a friend, family member or colleague about a product that they believe has improved their health or well being and they recommend it to you. Someone may or may not know you have chronic kidney disease and this advice may be fine for them but dangerous for you with kidney disease.

Several factors relating to herbal supplements are true for all users, with or without kidney disease. Herbal products often have multiple names, a common name and a plant derivative name. Always check the name of the product as well as the part of the plant used. Some common considerations include:

  • The herbal supplement market is not regulated for dose, content, purity of product; use a reputable brand and look for aUSP label on the product, this indicates that some review of the product has occurred
  • Frequent contamination with heavy metals is common with products manufactured in some foreign markets, especially developing countries
  • There are few studies to show effectiveness of herbal products and even less information in patients with chronic kidney disease
  • Herbal supplements may interact with prescription medication to either inhibit or enhance the medications effectiveness
  • Potassium is a mineral that may need to be regulated in chronic kidney disease stages, especially stage 5 dialysis. Herbs containing potassium include:

    • alfalfa
    • bai Zhi (root)
    • black mustard (leaf)
    • chicory (leaf)
    • coriander (leaf)
    • dandelion ( root, leaf)
    • American Ginseng
    • bitter melon (fruit, leaf)
    • Blessed Thistle
    • chervit (leaf)
    • Chinese boxthorn (leaf)
    • evening primrose
    • feverfew
    • genipap (fruit)
    • goto kola
    • Japanese honeysuckle (flower)
    • kudzu (shoot)
    • noni
    • purslane sage (leaf)
    • scullcap
    • turmeric (rhizome)
    • water lotus
    • dulse
    • garlic (leaf)
    • kelp
    • lemongrass
    • mugwort
    • papaya (leaf, fruit)
    • safflower (flower)
    • sassafras
    • shepherd's purse
    • stinging nettle (leaf)

    Phosphorus is a mineral that may need to be regulated with chronic kidney disease, somewhat prevalent at stage 3-4 CKD and very often in stage 5 CKD. Some herbs that contain phosphorus include:

    • American Ginseng
    • borage (leaf)
    • evening primrose
    • feverfew
    • horseradish (root)
    • milk thistle
    • onion (leaf)
    • pokeweed (shoot)
    • shepherd's purse
    • sunflower (seed)
    • turmeric (rhizome)
    • bitter melon
    • buchu (leaf)
    • coriander (leaf)
    • flaxseed (seed)
    • Indian sorrel (seed)
    • purslane
    • silk cotton tree (seed)
    • stinging nettle (leaf)
    • water lotus
    • yellow dock

    Herbs that are known to be contraindicated for chronic kidney disease, any stage, and transplant patients include:

    • astragalus
    • barberry
    • cat's claw
    • apium graveolens
    • creatine
    • goldenrod
    • horsetail
    • huperzineA
    • java tea leaf
    • licorice root
    • nettle, stinging nettle
    • oregon grape root
    • parsley root
    • pennyroyal
    • ruta graveolens
    • uva ursi
    • yohimbe

    Herbs that are generally regarded as safe with chronic kidney disease include:

    • acacia
    • aloe leaf
    • anise spice
    • bitter orange oil
    • cinnamon
    • coenzyme Q10, except with severe heart disease
    • melatonin, long term use has not been established
    • myrtle flavoring
    • rosemary leaf

    As with anyone, chronic kidney disease patients may have other health related medical history. A history of bleeding disorder puts you at high risk for adverse reactions to herbal supplementation. Pregnancy and lactation as well as children are also high risk categories.

    If you choose to start an herbal supplement, always consult your physician, dietitian, or other health care provider. Always update this at your doctor visits as a medication change. Only start one product at a time with a small dose. This way you can identify an adverse effect before any potential harm. Short term use of a product is recommended, a 2 week trial should tell you if you see any potential benefit.

    Herb-Drug Interaction Handbook, second edition. Sharon Herrr, RD, CDN. 2002 Consumer Lavs, National Center for Complementary and Alternative Medicine.

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