title: Nephrotoxicity of Natural Products.
abstract: BACKGROUND
  The manufacture and sale of natural products constitute a multi-billion dollar industry. Nearly a third of the American population admit to using some form of complementary or alternative medicine, with many using them in addition to prescription medications. Most patients fail to inform their healthcare providers of their natural product use and physicians rarely inquire. Annually, thousands of natural product-induced adverse events are reported to Poison Control Centers nationwide. Natural product manufacturers are not responsible for proving safety and efficacy, as the FDA does not regulate them. However, concerns exist surrounding the safety of natural products.
  
  
  CONCLUSIONS
  This review provides details on natural products that have been associated with renal dysfunction. We have focused on products that have been associated with direct renal injury, immune-mediated nephrotoxicity, nephrolithiasis, rhabdomyolysis with acute renal injury, hepatorenal syndrome, and common adulterants or contaminants that are associated with renal dysfunction.
  
  
  CONCLUSIONS
  The potential for natural products to cause renal dysfunction is justifiable. It is imperative that natural product use be monitored closely in all patients. Healthcare practitioners must play an active role in identifying patients using natural products and provide appropriate patient education.
authors.affiliation: Department of Pharmacy Services, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Nauffal
authors.forename: Steven
authors.initials: S
authors.lastname: Gabardi
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D001688:Biological Products / Q000009:adverse effects*; D007722:Health Knowledge, Attitudes, Practice; D006530:Hepatorenal Syndrome / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000473:pathology; D053040:Nephrolithiasis / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D011786:Quality Control; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D012206:Rhabdomyolysis / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology
chemical_list: D001688:Biological Products