| خلاصه مقاله | Background
Use of botanicals as dietary supplements and herbal medications is increasing. Many people falsely believe that “natural” products are harmless; therefore, they readily trust on herbal medicine. Most herbal medications induce their renal toxicity by aristolochic acid, which causes aristolochic acid nephropathy.
Discussion
Different types of traditional herbal medicine are used for treatment of various diseases in approximately 80% of population from different countries. It is not easy to assess all toxic effects of herbal products because of their ever-changing chemical composition based on different factors such as growing environment, seasonal cycle and extraction techniques. Therefore, no one can find a single product of a given plant that identically represents all samples of the same plant worldwide. Besides, ingestion of a single herbal medication can result in different outcomes, because pharmacokinetic modeling of botanicals including their absorption, distribution, metabolism, and excretion differ widely among different individuals. Up to now, as the toxicology of different herbal medication in children is not fully known and their antidotes are not introduced yet, botanical toxicity is very challenging. Moreover, Traditional herbal medications can induce nephrotoxicity by a wide variety of mechanisms, including diminishing renal blood flow, damaging compartments through the nephron, and urinary obstruction. Pathological changes accompanying renal toxicity caused by herbal medications may include: Fanconi syndrome with tubular atrophy, significant renal interstitial fibrosis, swelling of endothelial cells with thickening of afferent and interlobular arterioles, and even urothelial carcinoma.
Conclusion
There is increasing case reports of pediatric renal toxicity associated with using herbal products, so it is not safe to recommend herbal medications to children. |