Efficacy and Safety of CAM in Kidney Diseases

The evidence of benefits and safety of complementary and alternative medicine for kidney diseases are still dubious to both practitioners and general public. Chinese herbal medicines are the main CAM in treating chronic kidney disease as an adjunctive therapy to conventional medicine. Several meta-analyses of randomised controlled trials assessing the efficacy of CHM reported that Astragalus and Cordyceps seem to have a beneficial effect on the kidneys. Acupuncture, yoga and aromatherapy may alleviate symptoms in patients with ESRD, such as pain, anxiety and pruritus. This evidence should be interpreted with caution due to several limitations of the RCTs of CAM, i.e., small sample sizes, unclear randomisation and blinding. Acute kidney injury is the common nephropathy caused by herbal and dietary supplements, e.g. aristolochic acid. Dietary supplements may induce uncontrolled hyperkalemia and hyperphosphatemia in patients with advanced CKD. Unregistered herbal products from India and China may be adulterated by conventional medicines and heavy metals, which could cause AKI.