Critical review and analysis of information on the nephro-protective activity of medical plant extractions
Authors: Urakov A. L. 
Published: February 2025

Abstract.
Medicinal plants have been used since ancient times to prepare medicines in the form of extracts. Alcoholic and aqueous extracts of various parts of medicinal plants may contain potentially useful chemical compounds with biological activity. Therefore, extracts of some plants are still used to obtain effective and even potent medicines. It is believed that some medicinal plants contain chemical compounds that can have a protective effect on the kidneys in their diseases. However, the existing information on renal-tropic drugs obtained from medicinal plant raw materials and on the biological activity of extracts of medicinal plants does not allow us to draw unambiguous conclusions. A critical analysis of the information is required to sift out the "wheat from the chaff". In this regard, the article provides a critical review of the available information on the pharmacological activity of extracts of medicinal plants claiming to have a renal protective effect. A list of information and features of the therapy of kidney diseases using extracts of various medicinal plants is provided. It has been shown that the development of effective herbal therapy for the treatment of severe renal diseases requires a systematic study of such properties of finished drugs (extracts) as the volume of solvent (alcohol or water). Attention is drawn to the fact that the analysis of information is not possible without taking into account the single, daily and course dose of water (or alcohol), as well as the physico-chemical properties of the extract taken. Only after taking into account these factors of therapy, it will be possible to critically re-evaluate the therapeutic effect of the applied extracts of medicinal plants, taking into account the dose of water and the physico-chemical properties of the corresponding extracts for specific kidney diseases. Most likely, it is advisable to analyze the effectiveness of specific extracts in such kidney diseases as acute renal failure (ARF), nephrotic syndrome and chronic interstitial nephritis. It should be noted that in chronic renal failure (CRF), the patient may have a different glomerular filtration rate (GFR), namely, be below 30 ml/min. In this regard, different glomerular filtration in patients may have different effects on the pharmacokinetics of drugs, including water and table salt. In addition, it is reported that researchers ignoring the osmotic activity of extracts does not allow taking into account the osmotic component of their effect on diuresis. Also, the traditional approach to the treatment of critical conditions in renal failure includes dialysis and renal replacement therapy (RRT), which are difficult to access for some rural residents due to their geographical and economic location. Therefore, it is necessary to take into account the effect of medicinal plant extracts not only on patients, but also on the clinical effectiveness of dialysis and renal replacement therapy. The article analyzes the available information from other sides as well. In particular, it is reported that in such a medicinal collection as Ayurveda, some herbs have proven nephroprotective properties. In particular, it is reported that today extracts of plants such as Kanchnar (bauhinia raznolistnaya), Kushmanda (Benincasa Hispid) and Yeshtimadu (licorice naked) can have a more reliable renal protective effect. Nevertheless, the renal-protective activity of these plant extracts has not been scientifically substantiated.