Supplementary Table 2 Traditional medicines and edible plants associated with chronic renal disease (often presenting as de novo renal dysfunction).
Common name (latin
name)
Countries where
adverse effects
reported
Indication or purported
property
Toxic compound
or metabolite
Types of renal
injury reported
Other adverse events
reported
Outcomes
Bladderwrack (Fucus
vesiculosus)1
Italy
To induce weight loss,
thyroid stimulant,
hypoglycemic
Arsenic (from
growth of plant in
contaminated
water)
Tubular atrophy,
lymphocytic infiltrate,
proteinuria, ‘heavy
metal nephropathy’a
Polyuria, polydipsia,
glycosuria
Prolonged recovery
Chaparral (Larrea
tridentata)2–4
USA
Cancer, arthritis,
cleansing, tonic
Nordihydroguaiareti
c acid (NGDA)
Renal cysts, low
grade cystic renal cell
carcinoma
Contact dermatitis,
hepatitis
Stable condition after
nephrectomy
Chinese herbs
(Aristolochia fangchi;
Aristolochia
clematis)5–10
Europe, China, USA
To induce weight loss, to
improve well being, liver
tonic, menopause,
“almost any ailment”
Aristolochic acid
Interstitial fibrosis,
tubular atrophya,
Fanconi syndrome,
AKI with
rhabdomyolysis
Vomiting, gastroenteritis,
muscle spasms, urothelial
carcinoma
End-stage renal disease,
Balkan nephropathy
Germanium5,11,12
Germany, Korea
Immunostimulant, antiinflammatory
Germanium
dioxide, alkyl
germanium
ATN, tubular atrophy,
interstitial fibrosisa
Anemia, muscle wasting,
peripheral neuropathy
Persistent renal
dysfunction
L-Lysine13
USA
Oral herpes
L-lysine
Fanconi’s syndrome,
tubulointerstitial
nephritis. Prominent
proximal tubular
lysosomes, ATNa
Fatigue
End-stage renal disease
Mesotherapy
(comprises drugs,
homeopathic
medicines, plant
extracts and
vitamins)14
Ireland
To induce weight loss
Multiple possible
compounds
Tubulointerstitial
fibrosisa
Anemia
End-stage renal disease
Willow bark (Salix
daphnoides)3,15
Europe
Analgesic
Salicylate
Renal dysfunction
leading to papillary
necrosis
Upset stomach, peptic and
duodenal ulcers, bleeding,
tinnitus, nausea, vomiting,
diarrhea
Chronic kidney disease
a
Diagnosis made by biopsy and/or post-mortem. Abbreviations: ATN, acute tubular necrosis; AIN, acute/allergic interstitial nephritis; AKI, acute kidney injury.
References
1
Conz PA et al. (1998) Fucus vesiculosus: a nephrotoxic alga? Nephrol Dial Transplant 13: 526–527
2
Steenkamp V and Stewart MJ (2005) Nephrotoxicity associated with exposure to plant toxins, with particular reference to Africa. Ther Drug Monit
27: 270–277
3
Gabardi S et al. (2007) A review of dietary supplement-induced renal dysfunction. Clin J Am Soc Nephrol 2: 757–765
4
Smith AY et al. (1994) Cystic renal cell carcinoma and acquired renal cystic disease associated with consumption of chaparral tea: a case report. J
Urol 152: 2089–2091
5
Luck BE et al. (1999) Renal and other organ failure caused by germanium intoxication. Nephrol Dial Transplant 14: 2464–2468
6
Debelle FD et al. (2008) Aristolochic acid nephropathy: A worldwide problem. Kidney Int 74: 158–169
7
Debelle F et al. (2002) Aristolochic acids induce chronic renal failure with interstitial fibrosis in salt-depleted rats. J Am Soc Nephrol 13: 431–436
8
Kabanda A et al. (1995) Low molecular weight proteinuria in Chinese herbs nephropathy. Kidney Int 48: 1571–1576
9
Krumme B et al. (2001) Reversible Fanconi syndrome after ingestion of a Chinese herbal 'remedy' containing aristolochic acid. Nephrol Dial
Transplant 16: 400–402
10
Vanherweghem J et al. (1993) Rapidly progressive interstitial renal fibrosis in young women: Association with slimming regimen including Chinese
herbs. Lancet 341: 387–391
11
Schauss AG (1991) Nephrotoxicity in humans by the ultratrace element germanium. Ren Fail 13: 1–4
12
Kim KM et al. (1998) Nephropathy and neuropathy induced by a germanium-containing compound. Nephrol Dial Transplant 13: 3218–3219
13
Lo JC et al. (1996) Fanconi's syndrome and tubulointerstitial nephritis in association with L-lysine ingestion. Am J Kidney Dis 28: 614–617
14
Farrell J et al. (1995) Renal failure associated with alternative medical therapies. Ren Fail 17: 759–764
15
Schwarz A (1993) Beethoven's renal disease based on his autopsy: a case of papillary necrosis. Am J Kidney Dis 21: 643–652