Bupleurum and kidney disease

Bupleurum & its Clinical Use in Kidney Disease

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Bupleurum falcatum, commonly known as just Bupleurum, is a woody shrub native to Europe, Asia, and North America. Medicinally it is the root of the plant that is used in many Japanese and Chinese Herbal Medicine decoctions and formulas. Bupleurum is specific for those with immune or inflammatory causes of impaired kidney function. Clinical studies have shown some of the active constituents in Bupleurum are capable of reducing raised urinary proteins up to 48%. Bupleurum has also been shown to have a protective effect on nephrons. This is a great herb for those with autoimmune, inflammatory type causes of kidney disease.

So now that you have a quick snap shot of this amazing herb lets dive into the specifics to see what makes this herb suitable for those diagnosed with chronic kidney disease.

Bupleurum and kidney disease

Traditionally, Bupleurum has been used to treat a huge range of conditions including:

  • Fever
  • Infections like the flu
  • Fatigue
  • Headaches
  • Tinnitus
  • Liver disorders
  • Malaria
  • Epilepsy
  • Pain
  • Muscle Cramps
  • Asthma
  • Ulcers
  • Insomnia
  • Hyperlipidemia
  • Hepatitis
  • Cancer
  • Chronic Fatigue
  • Diabetes
  • Elevated Cholesterol
  • Kidney Disease

That is quite a huge list of conditions, many of them unrelated. So what is it about Bupleurum that makes it successful in treating so many varied health conditions?

Therapeutic Actions of Bupleurum

  • Anti-inflammatory
  • Hepatoprotective
  • Antitussive
  • Diaphoretic
  • Immune Modulation
  • Protects the Liver & Kidneys from toxic damage
  • Hepatoprotective
  • Nephroprotective
  • Antioxidant

Bupleurum has a wide-reaching list of therapeutic actions which is why it is so effective in such a wide range of health conditions. Let us have a closer look at some of these actions and how they might benefit someone diagnosed with Chronic Kidney Disease.

Anti Inflammatory

Bupleurum is abundant in a specific saponin called saikosaponin, which is responsible for the majority of Buplerum’s therapeutic actions, including that of its anti-inflammatory action. Saikosaponins can both induce the secretion of endogenous corticosterone and potentiate its anti-inflammatory action. Corticosterone, more commonly known as cortisol, is the main hormone produced by the adrenal glands in response to stress. It is also a very powerful anti-inflammatory, hence why many chronic inflammatory conditions are treated with prescription corticosteroids. Bupleurum can enhance the body’s production of this powerful hormone, which is why it is such an effective anti-inflammatory herb. Studies have shown that administering a combination of Bupleurum and corticosteroid medication increased the anti-inflammatory activity compared to just using corticosteroids alone. 

saikosaponin

This makes Buplerum a herb of choice when we are dealing with inflammatory-type health conditions that may affect the function and health of kidney tissues. 

If you follow our blogs and YouTube channel or are a part of our Kidney Disease Solution family, you will know we talk a lot about inflammation and the detrimental effects that inflammation has on the kidneys. Inflammation is the driver of most chronic diseases, so having a herb like Buplerum, being so effective as an anti-inflammatory agent, is exciting and good to have in our arsenal of natural remedies in the treatment of inflammatory, immune induced kidney damage.  

https://pubmed.ncbi.nlm.nih.gov/31614667/

Immune-Modulation

Saikosaponins have also been shown to be effective immune enhancers. They do this by stimulating the production of macrophages and lymphocytes produced by the immune system. This kind of action is what gives Bupleurum its ability to treat things like influenza, fever, malaria, and a host of other viral-type infections.

Human clinical trials showed that adults infected with H1N1 influenza who took a Bupleurum containing herbal extract to be as effective as oseltamivir, an antiviral drug, improving symptoms by at least 30% over 5 days. This might also make it a herb to think about if one is infected with SARS-CoV-2, several clinical trials are suggesting the use of this herb for just this. 

https://pubs.acs.org/doi/10.1021/acs.jmedchem.0c00626

Anti Cancer

In rats transplanted with Ehrlich tumors, Bupleurum demonstrated an increase in the endogenous production of tumor necrosis factor (TNF) activity. After two weeks tumor size was reduced to 15% compared to the control group, and two-thirds of the mice were cured compared to no cures in the control group. That is a pretty impressive stat! Again some of Buplerum’s ability to reduce tumor activity was thought to be done through its anti-inflammatory and antioxidant actions. 

Liver cancer research in adults with hepatitis B and liver cirrhosis showed that taking a specific Bupleurum-containing product reduced the risk of developing liver cancer when compared to conventional treatment alone. 

https://pubmed.ncbi.nlm.nih.gov/3851690/

Cholesterol-Lowering Activity

Saponins, a constituent in many plants including Bupleurum, are known to have cholesterol-lowering abilities. Bupleurum was shown to specifically do this via its anti-inflammatory action and its ability to increase the excretion of bile from the gallbladder. Bile binds to cholesterol and stops it from entering the bloodstream, hence its ability to lower cholesterol. 

This again would make Buplerum a herb to consider if you have high cholesterol or heart disease related to a diagnosis of kidney disease. 

https://pubmed.ncbi.nlm.nih.gov/15325730/

Nephroprotective Activity

Studies have shown that injections of Saikosaponins significantly decrease urinary protein excretion in rats with chemically induced proteinuria. Urinary protein was reduced by up to 48% in animals treated with this injection and the degree of abnormality in the glomerular epithelial cells was lower. This suggests that the chemical constituents found in Bupleurum have a protective mechanism on kidney cells. 

An injection of various types of Saikosaponins demonstrated the ability of Bupleurm to reduce inflammation in kidney tissue, known as antinephritic activity. The same study showed that urinary protein excretion and elevations of serum cholesterol were prevented and damage to kidney tissues inhibited. It was thought that this action was achieved through Buplerum’s ability to act as an antioxidant.

Anti oxidant effect

Oxidative damage is well recognized to play a role in the progression of many disease states including cancer, atherosclerosis (plaque in the arteries), cardiovascular disease, diabetes, and kidney disease. Oxidative damage caused by reactive oxygen species (ROS) damages vital cellular structures leading to permanent damage to cells. Bupleurum supported free radical scavenger activity (the clean up of oxidative damage) by supporting glutathione peroxidase activity. 

https://pubmed.ncbi.nlm.nih.gov/2045012/

Herb / Drug Interactions

 

Immunosuppressants

Due to Buplerum’s ability to stimulate immune function, it might, theoretically, interfere with immunosuppressive therapy. This would include any medications being used as a result of a kidney transplant, and drugs used for autoimmune diseases like Lupus and MS.

Antidiabetic Drugs

Animal research suggests that the saikosaponins contained in Bupleurum might increase blood glucose levels. Theoretically, the use of Bupleurum and antidiabetic drugs might interfere with blood glucose control. If you have been diagnosed with diabetes then I would recommend you speak to your health care practitioner before commencing this herb, and if you do decide to take it monitor your blood levels closely and discontinue if you see any evidence of a spike in blood glucose levels.

Anticoagulant / Antiplatelet Medications

In vitro studies suggest that Bupleurum can inhibit platelet aggregation. Meaning that taking this herb alongside medications like aspirin, Plavix, NSAIDs, and warfarin might increase the risk of bleeding. This can be monitored via a regular blood test to check your INR levels.

Safety

When used within its correct dosage range, Bupleurum seems to be a very safe herb to take for the general population. 

Specific Diseases Interactions

 

Auto-Immune Diseases

Due to Bupleurum’s ability to stimulate immune functions, patients with autoimmune diseases such as Multiple Sclerosis, Lupus, or Rheumatoid arthritis will want to use Bupleurum with caution. Of course, the mechanisms of this herb are far more sophisticated than just an increase in immune activity. I often use this herb, under strict supervision, in autoimmune conditions, specifically MS, IgA Nephropathy, and Lupus to decrease systemic inflammation. But I do this in conjunction with the patient’s GP and use regular blood tests to monitor how things are going. If you do have an autoimmune disease and want to use this herb, I suggest only doing it in conjunction with a knowledgeable Naturopathic doctor or integrative medical practitioner.

Bleeding Disorders

In Vitro studies (Meaning in a petri dish) suggest that saikosaponins can inhibit platelet aggregation. Theoretically, that means that Bupleurum can increase the risk of bleeding when used by anyone with a bleeding disorder. Like with autoimmune diseases if you choose to use this herb please do it under the supervision of a knowledgeable health care provider. 

Diabetes

Since it is possible that Bupleurum can increase blood glucose levels, if you have been diagnosed with diabetes then the use of Bupleurum is cautioned. Again using this herb if you have active diabetes should only be done under the supervision of a qualified healthcare provider and blood glucose levels should be monitored closely. 

Dosage 

  • 3-12g per day of the dried root
  • 4-8mls per day of a 1:2 liquid extract

Because I work with so many patients diagnosed with autoimmune diseases, Bupleurum is a herb that I use a lot. If I am honest it is one of my favorite herbs due to its large range of therapeutic actions and mechanisms. 

As with any new medications and supplements, make sure that you consult with your healthcare provider to make sure that this herb is appropriate for your individual use.

I hope by now you have a love and appreciation for the amazing herb, known as Bupleurum. 

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