Were herbal remedies not recommended in the new KDIGO guideline?

摘要

With the coining of the New Year, the KDIGO (Kidney Disease: Improving Global Outcomes) group issued a practical guideline on chronic kidney disease (CKD).We benefit greatly from this guideline, which improves our understanding of the management of CKD and helps us make decisions in clinical practice. However, we have some doubt on one IB level recommendation (defined as a suggestion based on a moderate quality of evidence) which suggests not using herbal remedies in people with CKD.After reading carefully the references KDIGO quoted for this recommendation, we noticed that only herbs containing aristolochic acids are referred to. As a matter of fact, with deepening of knowledge on the nephrotoxicity of aristolochic acids, traditional Chinese medical doctors have rejected such kinds of herbs, as well as some drugs made from minerals and animals. Actually, the National Kidney Foundation also released a list of herbs that may be toxic to the kidneys. (http://www.kidney.org/atoz/content/herbalsupp.cfm)