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Natural products like polysaccharides and TCM formulas may modulate gut microbiota to protect renal functionNatural Products May Help Manage Chronic Kidney Disease Symptoms

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Key Takeaway
Note that natural products may offer a theoretical basis for gut-mediated renal protection in various kidney diseases.

This systematic review explores the impact of natural products, specifically natural polysaccharides, traditional Chinese medicine formulas, and plant polyphenols, on the gut-kidney axis in patients with chronic kidney disease (CKD) and dialysis-dependent individuals. The scope includes conditions such as IgA Nephropathy, Lupus Nephritis, and Hypertension-associated Nephropathy.

The review synthesizes evidence regarding how gut dysbiosis contributes to the accumulation of uremic toxins like indoxyl sulfate, p-cresyl sulfate, and TMAO, while reducing protective metabolites like SCFAs and indole-3-aldehyde. These changes are linked to inflammation and fibrosis. The authors argue that natural products may offer therapeutic potential by remodeling gut microbiota, repairing mucosal barrier function, and balancing metabolic profiles to provide renal protection.

A key limitation noted is that the therapeutic potential of these substances is presented as a theoretical foundation rather than established clinical outcomes. Clinical evidence for specific dosages or long-term safety profiles was not reported. These findings suggest natural products may offer strategies for early prevention and retardation of disease progression, but further research is required to establish definitive clinical efficacy.

How this fits prior evidence

This review addresses a gap in the management of chronic kidney disease by exploring gut-kidney axis modulation. While previous evidence has explored targeting cannabinoid receptors as an emerging, low-certainty therapeutic avenue for CKD and AKI, this study focuses on natural products like polysaccharides and plant polyphenols to achieve similar goals of renal protection through microbiota remodeling.

This review looked at how natural products, such as plant polyphenols, traditional Chinese medicine formulas, and natural polysaccharides, might affect people with chronic kidney disease (CKD). The research focused on the link between the gut and the kidneys. In many cases, an imbalance in gut bacteria can lead to a buildup of harmful toxins and cause inflammation or scarring in the kidneys.

The findings suggest that these natural products could help by reshaping gut bacteria and repairing the intestinal barrier. By balancing metabolic profiles, these substances may offer a way to protect kidney function and slow down disease progression for those with various conditions, including lupus nephritis and IgA nephropathy.

It is important to note that this review focuses on theoretical foundations and potential strategies rather than proven clinical results for specific products. Because the evidence is based on theoretical models of how these substances work, they are not currently established treatments. Patients should talk to their doctor before starting any new supplements or herbal formulas.

What this means for you:
Natural products may offer a way to protect kidneys by improving gut health, but more clinical research is needed.

Common questions

What natural products are being studied for kidney health?

The review looks at natural polysaccharides, traditional Chinese medicine formulas, and plant polyphenols. These substances are studied because they may help remodel gut microbiota, repair the intestinal mucosal barrier, and balance metabolic profiles to provide protection for the kidneys.

How does gut health affect kidney disease?

An imbalance in gut bacteria can lead to an accumulation of uremic toxins like indoxyl sulfate and p-cresyl sulfate. These toxins can trigger inflammation and fibrosis in the kidneys. Improving the gut environment may help reduce these harmful effects.

Are these natural products a proven treatment for kidney disease?

The research shows potential strategies for early prevention and slowing disease progression, but it is based on theoretical foundations rather than established clinical outcomes. You should consult your doctor before using any specific natural product to treat a medical condition.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedJul 2026
View Original Abstract ↓
Gut microbiota exert core regulatory effects on systemic metabolic homeostasis and immune balance under physiological and pathological conditions. Marked gut dysbiosis occurs during the progression of chronic kidney disease (CKD), characterized by abnormal enrichment of opportunistic pathogens and depletion of beneficial commensal bacteria. This pathological alteration leads to excessive accumulation of uremic toxins including indoxyl sulfate, p-cresyl sulfate and trimethylamine N-oxide (TMAO), as well as sharp reductions in the synthesis of intestinal protective metabolites such as short-chain fatty acids (SCFAs) and indole-3-aldehyde. The imbalance between harmful and protective metabolites persistently triggers renal inflammatory activation and interstitial fibrosis via activating multiple signaling pathways, including the renin-angiotensin system, oxidative stress, Toll-like receptor 4, aryl hydrocarbon receptor, IκB/NF-κB, Keap1/Nrf2, NLRP3 inflammasome and ferroptosis. This review systematically summarizes the pathological correlations between gut microbiota disturbance and various renal disorders, namely diabetic kidney disease, membranous nephropathy, lupus nephritis, IgA nephropathy, hypertension-associated nephropathy and dialysis-related renal injury, and clarifies the universal mechanisms and disease-specific characteristics underlying gut-kidney axis-mediated progression of different subtypes of kidney diseases. Natural products represented by natural polysaccharides, traditional Chinese medicine formulas and plant polyphenols are capable of remodeling gut microbiota composition, repairing intestinal mucosal barrier function, balancing microbial metabolic profiles and regulating gut-kidney axis homeostasis, thereby exerting renal and multi-organ protective effects in patients with CKD and dialysis-dependent individuals. Targeted modulation of intestinal microecology and intervention against gut-kidney axis dysfunction using natural products provide novel strategies for early prevention and control of CKD, disease progression retardation and prognosis improvement in dialysis patients, and also lay a theoretical foundation for the development and clinical translational application of novel therapeutic targets for kidney diseases.
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