Astragalus and Chronic Kidney Disease

Astragalus and its Role in Chronic Kidney Disease

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Astragalus membranaceus (also called Huang Qi or milk vetch) is a plant native to Asia and is considered to be one of the most important herbs in Traditional Chinese medicine (TCM). It has a long history as an immune system booster and is one of the most widely used herbs in TCM for treating kidney disease. 

Today I thought we’d have a look at some of the actions of Astragalus that make it such a key herb in the treatment of kidney disease. 

Actions of Astragalus

  •     Kidney tonic
  •     Balances immune system
  •     Immune enhancer
  •     Anti-diabetic
  •     Cardiovascular tonic
  •     Diuretic
  •     Energy tonic
  •     Adrenal gland tonic
  •     Lowers blood pressure
  •     Antioxidant

Anti-diabetic actions

Astragalus has a long history for the treatment of diabetes and diabetes related symptoms in China and given that diabetes is the number one cause of kidney disease I wanted to start off discussing the ways that astragalus is of benefit in diabetes and diabetic kidney disease. 

Type 2 diabetes develops over a long period of time. During this time the body becomes more and more resistant to insulin and the pancreas gradually loses the capacity to produce enough insulin. 

The function, quality and number of pancreatic beta cells (the insulin producing cells) decrease progressively, this is why blood sugar levels increase over time and often diabetic medication has to be increased or a second medication or insulin added to the mix. 

Astragalus lowers blood sugar levels by actually improving the insulin secretion activity of pancreatic beta cells by protecting them from damage, increasing the number of pancreatic beta cells and improving their function. It also reduces insulin resistance which means that the cells in muscles, body fat and liver start listening to the signal that insulin sends out- which is to take glucose out of the bloodstream and put it into your cells, resulting in lowered blood sugar levels. 

Numerous studies have been conducted in both animals and humans that demonstrate that astragalus is a promising complementary medication in the management of diabetic kidney disease. 

A meta-analysis of 25 studies that included 945 patients with diabetic kidney disease and 859 control subjects found that astragalus treatment resulted in significantly improved creatinine clearance levels, lower blood urea nitrogen (BUN), lower creatinine levels, reduced urinary protein loss.

Controlling blood sugar levels is one of the keys when it comes to protecting your kidneys (and other organs) from damage but that’s not the only way astragalus protects the kidneys.

Let’s have a look at the other ways astragalus protects the kidneys and helps to improve their function.

Astragalus in CKD and diabetes

https://www.frontiersin.org/articles/10.3389/fphar.2020.00349/full

Anti-inflammatory & Antioxidant

Inflammation and oxidative damage are two of the key contributory factors to the development and progression of CKD regardless of the cause. Astragalus has both anti-inflammatory and antioxidant actions which plays a role in healing the kidneys and preventing further damage from occurring. 

Anti oxidant effect

Anti-fibrotic

A final, common pathway in CKD is fibrosis, the formation of internal scar tissue. Renal scarring results in a progressive loss of renal function and if not prevented or treated, ultimately leads to end-stage kidney disease. Astragalus has been shown to prevent this fibrosis from occurring and it does this primarily through reducing transforming growth factor beta (TGF-B) which has long been considered as a key mediator of renal fibrosis.

Improves kidney blood flow

When your kidneys don’t get enough blood, this disrupts both your blood pressure and the balance of fluid throughout your body. In an attempt to increase blood flow to your kidneys, a series of hormonal interactions kick into gear, your arteries constrict, and your body retains salt and water to increase blood pressure and volume. As we know, high blood pressure is the second leading cause of kidney disease and contributes to damage to the kidneys. Reduced blood flow also means reduced oxygen delivery to the kidneys which results in damage. Astragalus has been shown to improve blood flow to the kidneys which also ensures adequate oxygen delivery and prevents damage from occurring. 

Reduces protein loss in urine

Loss of protein in urine is a common symptom of kidney disease but that’s not all, it also accelerates the progression of kidney disease. Clinical trials have consistently shown that whenever proteinuria is decreased by treatments, progression to end-stage kidney disease is reduced. Multiple studies have shown that astragalus can reduce proteinuria in both animal models and humans. 

Improved albumin levels

Albumin is a blood protein that makes up a significant portion of the blood plasma. As the main protein in blood, albumin plays a role in many functions including maintaining pressure in the blood vessels and transporting substances such as vitamins,  hormones and medications. People with CKD commonly have low albumin levels because of the loss of protein (albumin) in urine. Low albumin levels can result in swelling of the feet or hands, fatigue, loss of appetite and dry/itchy skin. Astragalus has been shown to increase albumin levels in the blood so may help with reducing the symptoms caused by low albumin.

Lowers blood pressure

Over time, high blood pressure constricts and narrows the blood vessels which eventually damages and weakens them throughout the body, the narrowing also reduces blood flow. If the kidneys’ blood vessels are damaged, they may no longer work properly and when this happens, the kidneys aren’t able to remove all wastes and extra fluid from your body. This extra fluid can raise your blood pressure even more, creating a dangerous cycle and causing more damage to the kidneys. Astragalus can lower blood pressure and prevent/reduce damage to the kidneys. One of the ways that astragalus lowers blood pressure is by increasing nitric oxide synthesis which increases vasodilation- the relaxation of blood vessels. 

Prevents hypertensive kidney damage

Studies on astragalus injections have shown that it may prevent or reduce the damage to the kidneys caused by high blood pressure. Astragalus was more effective than a placebo at lowering blood urea nitrogen (BUN), creatinine clearance rate and protein loss in urine in people with kidney damage caused by elevated blood pressure.

Diuretic

Astragalus also has diuretic properties which can take the workload off the heart in heart failure and reduce kidney failure related swelling. Its diuretic properties also contribute to its blood pressure lowering effects. 

Other benefits of Astragalus

As you can see, astragalus has many benefits when it comes to healing the kidneys and protecting them from damage but that’s not all it does! Some other benefits of astragalus include:

  • Astragalus can increase red blood cell and haemoglobin levels which make it useful in the treatment of anaemia.
  • Astragalus has been prescribed for centuries for general debility and chronic illness and to increase one’s overall vitality. This makes it a useful treatment for fatigue.
  • Astragalus contains beneficial plant compounds that may enhance your immune system, reducing the risk of infections and illness. it is particularly beneficial for chronic immune weakness.
  • Astragalus is also classified as an adaptogen which means it helps the body deal with and adapt to stress.

Therapeutic dose: 2g to 4g a day.

Cautions and Contraindications

According to the principles of TCM, astragalus shouldn’t be taken during the acute stages of an infection. Astragalus should also be avoided alongside immunosuppressive medication due to its immune enhancing actions.

Astragalus may potentiate the effect of diabetic medication and blood pressure medication so closer monitoring of blood sugar levels and blood pressure is needed.

And don’t forget….

Before starting on astragalus, please consult your doctor or naturopath to make sure it is suitable for you and your situation. 

So, there you go, there’s a snapshot of the benefits of astragalus in the treatment of kidney disease. As you can see, it’s a beneficial herb for kidney disease regardless of the cause with particular benefits when it comes to kidney disease caused by diabetes and high blood pressure. 

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