Effective Integrated Treatment Strategies for Chronic Glomerulonephritis: Why Relying Solely on Traditional Herbal Medicine Isn't Supported by Evidence

Chronic glomerulonephritis (CGN) is a complex, progressive kidney disorder characterized by persistent inflammation of the glomeruli—the tiny filtering units in the kidneys. Left unmanaged, it can lead to declining renal function, hypertension, proteinuria, and eventually chronic kidney disease (CKD) or end-stage renal disease (ESRD). Given its long-term implications, patients often seek complementary approaches—including traditional herbal remedies—hoping for gentler or more "natural" solutions. However, evidence-based medicine clearly shows that monotherapy with traditional Chinese herbal formulas alone is neither scientifically validated nor clinically effective for curing or halting CGN progression.

Why Herbal-Only Approaches Fall Short

Despite centuries of use in traditional practice, no rigorous clinical trials or systematic reviews have demonstrated that herbal monotherapy leads to sustained remission, reduced proteinuria, or improved estimated glomerular filtration rate (eGFR) in chronic glomerulonephritis. In fact, major international guidelines—including those from the Kidney Disease: Improving Global Outcomes (KDIGO) and the American College of Physicians (ACP)—emphasize that immunosuppressive and renin-angiotensin-aldosterone system (RAAS)–blocking agents remain the cornerstone of treatment. Relying exclusively on herbal preparations may delay proven interventions and increase the risk of irreversible kidney damage.

The Limited Role of Specific Herbal Compounds

One compound often cited in nephrology literature is tripterygium glycosides (e.g., tripterygium wilfordii polyglycoside tablets, commonly known as Lei Gong Teng extracts). While some small-scale studies suggest modest anti-inflammatory and immunomodulatory effects, the overall evidence remains weak: effect sizes are inconsistent, safety concerns—including hepatotoxicity and reproductive toxicity—are well documented, and large randomized controlled trials are lacking. As such, these agents are not approved as first-line or standalone therapy by the U.S. FDA, EMA, or China's NMPA for primary glomerular diseases.

What Does Evidence-Based Practice Recommend?

Current best practices support a complementary—not alternative—approach:

• First-line pharmacotherapy: ACE inhibitors (e.g., lisinopril) or ARBs (e.g., losartan) to control blood pressure and reduce proteinuria;
• Immunosuppression when indicated: Corticosteroids, mycophenolate mofetil, or calcineurin inhibitors based on histopathology and disease activity;
• Adjunctive herbal support—only under expert supervision: Certain standardized, quality-controlled herbal formulations may help alleviate symptoms like fatigue or mild edema—or support liver detoxification pathways—but must never replace guideline-directed care.

  Crucially, any integrative plan should involve close collaboration between a board-certified nephrologist and a licensed, Western-trained herbalist familiar with drug–herb interactions—especially since herbs like Astragalus, Salvia miltiorrhiza, or Rehmannia may influence anticoagulation, blood pressure, or renal perfusion.

  Prioritize Safety, Science, and Sustainability

  Patients deserve transparent, patient-centered care rooted in reproducible science—not anecdote or tradition alone. While cultural respect and holistic wellness matter deeply, kidney health demands precision, monitoring, and timely intervention. Regular eGFR tracking, urine albumin-to-creatinine ratio (UACR) testing, and renal ultrasound are non-negotiable components of management. Always consult your nephrology team before introducing herbal supplements—and never discontinue prescribed medications without medical guidance.

  In summary: There is no credible scientific basis for using herbal-only regimens to treat chronic glomerulonephritis. The most effective, safe, and sustainable path forward combines modern nephrology standards with carefully selected, evidence-informed complementary strategies—guided by data, not dogma.