International Journal of Trend in Scientific Research and Development (IJTSRD)

Volume 6 Issue 7, November-December 2022 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470

Study of Medicinal Plants in Management of Naphrotoxicity

Ms. Jyoti Singh1, Dr. Bishnu Kumar2, Dr. Shailesh Gupta3
1
Department of Pharmacology, Mansarovar Global University, Bilkisganj, Madhya Pradesh, India
2
Associate Professor, BAMC Medical College, Uttar Pradesh, India
3
Professor in Department of Pharmacology, Mansarovar Global University, Bilkisganj, Madhya Pradesh, India

ABSTRACT How to cite this paper: Ms. Jyoti Singh |

Nephrotoxicity is one of the most common kidney problems and Dr. Bishnu Kumar | Dr. Shailesh Gupta
occurs when body is exposed to a drug or toxin. A number of "Study of Medicinal Plants in
therapeutic agents can adversely affect the kidney resulting in acute Management of Naphrotoxicity"
Published in
renal failure, chronic interstitial nephritis and nephritic syndrome.
International
Agents Which Causes Nephrotoxicity Drugs, diagnostic agents &
Journal of Trend in
chemical are well known to be nephrotoxic. Scientific Research
To avoid the side effect of synthetic drug there is need to develop a and Development
safe and effective Polyherbal In view of foregoing consideration. Our (ijtsrd), ISSN:
2456-6470, IJTSRD52459
present study aims at the scientific validation of nephroprotective and
Volume-6 | Issue-7,
antioxidant properties of selected plant and formulation of suitable
December 2022, pp.962-967, URL:
novel dosage so that new herbal drug will come in the market. www.ijtsrd.com/papers/ijtsrd52459.pdf
KEYWORDS: Bark extract of Ficus racemosa, medicinal plants,
toxicity, antioxidant and Nephprrootective activity Copyright © 2022 by author (s) and
International Journal of Trend in
Scientific Research and Development
Journal. This is an
Open Access article
distributed under the
terms of the Creative Commons
Attribution License (CC BY 4.0)
(http://creativecommons.org/licenses/by/4.0)

Materials and methods

1. References of Nephrotoxic drugs have been antibiotics, NSAID’s, chemotherapeutic agents have
collected from the classical books of Ayurveda been added to the therapeutic arsenal in recent years.
2. All the data is compiled, analyzed and discussed Exposure to chemical reagents like ethylene glycol,
through in depth for Medicinal Plants for its carbon tetrachloride, sodium oxalate and heavy
management of Naphrotoxicity from authentic metals such as lead, mercury, cadmium and arsenic
sources. also induces nephrotoxicity. Prompt recognition of
3. Ayurvedic and modern approach have been the disease and cessation of responsible drugs are
compiled in this review usually the only necessary therapy. Nephroprotective
agents are the substances which possess protective
Aim and Objectives
Our present study aims at the scientific validation of activity against Nephrotoxicity. Medicinal plants have
curative properties due to the presence of various
nephroprotective and antioxidant properties of
selected plant so that new herbal drug will come in complex chemical substances. Early literatures have
the market. prescribed various herbs for the cure of renal
disorders. Coadministration of various medicinal
INTRODUCTION plants possessing nephroprotective activity along with
Nephrotoxicity is one of the most common kidney different nephrotoxic agents which may attenuate its
problems and occurs when body is exposed to a drug toxicity. The term renal failure primarily denotes
or toxin. A number of therapeutic agents can failure of the excretory function of kidney, leading to
adversely affect the kidney resulting in acute renal retention of nitrogenous waste products of
failure, chronic interstitial nephritis and nephritic metabolism in the blood. In addition to this, there is a
syndrome because there is an increasing number of failure of regulation of fluid and electrolyte balance
potent therapeutic drugs like aminoglycoside along with endocrine dysfunction. The renal failure is

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fundamentally categorized into acute and chronic these system in their fundamental principle and
renal failure.1-6. practices.
Ayurveda and other traditional medical practitioners Herbal drugs are constitutes a major part in all the
from different countries have claimed for centuries traditional system of medicine. Herbal medicine is a
that extracts of plants can be effectively used for the triumph of popular therapeutic diversity. Plants above
alleviation of different types of liver diseases. But all other agent have been used for medicine from time
most claims are anecdotal and very few have received immemorial because they have fitted the immediate
adequate medical or scientific evaluation. Except for personal need. there are approximately 1250 Indian
the use of appropriate vaccine for the treatment of plant medicinal plant ,which are used in formulating
hepatitis caused by viral infection, there are few of therapeutic preparation according to ayurveda and
effective plants that cure liver diseases. Therefore, it other traditional system of medicines.
is not surprising that a considerable interest has been Herbal drugs are constitutes a major part in all the
developed in the examination of those numerous traditional system of medicine.. Herbal medicine is a
worldwide traditional plant remedies, which are used triumph of popular therapeutic diversity.
for such treatment and that on recent years
investigations are carried out to provide experimental Agents Which Causes Nephrotoxicity Drugs,
evidence, which confirms that many of these plants diagnostic agents & chemical are well known to be
do indeed have Nephroprotective properties. Recent nephrotoxic. The following are some of the important
progress in the study of such plant has resulted in the nephrotoxic agents7.
isolation of about 170 different phytoconstituent from A. Heavy metal: Mercury, arsenic, lead, bismuth
plants belonging to about 55 families, which exhibit
Nephroprotective activity. raditional system of B. Antineoplastic agents
medicine has plants, used for centuries for protecting Alkylating agents: Cisplatin, cyclophosphamide
liver for the treatment of liver dysfunctions. Ancient
literature also mentions herbal medicine is related Nitrosoureas: Streptozotocin, Carmustine, Lomustine
diseases namely Memory lose, Osteoporosis, Diabetic & Semustine
wounds, Immune and Liver disorders etc, for which Antimetabolites: High dose Methotrexate, Cytosine
in modern medicine or only palliative therapy is Arabinose, high dose 6-thioguanine, 5-flurouracil
available. Antitumor antibiotics: Mitomycin, Mithramycin,
Indian system of traditional medicine it is presumed Doxorubicin Biologic agents: Recombinant leukocyte
that the knowledge of ayurveda is given by gods of a and interferon
different world. it is accepted as the oldest written C. Antimicrobial agents: Tetracycline, Acyclovir,
medical system that is also supposed to be more Pentamidine, Sulphadiazine, Trimethoprin,
effective in certain cases than modern therapies. Rifampicin, Amphotericin
India, a veritable emporium of plants, occupies the D. Aminoglycosides : Gentamycin, Amikacin,
topmost place among the leading users of herbal Kanamycin, Streptomycin
medicines. India the abode of Ayurvedic system of
E. Miscellaneous Radiocontrast agents: Non-
medicine, assigns much importance to the
steroidal anti-inflammatory agents (NSAID’s):
pharmacological aspects of many plants. Herbal drugs
Ibuprofen, Indomethacin, Aspirin etc.
are playing an important role in health care
programmes worldwide and there is a resurgence Acute renal failure (ARF) refers to the sudden and
interest in herbal medicines for treatment of various usually reversible loss of renal function which
ailments including haptopathy. develops over a period of days or weeks. There are
many causes for acute renal failure which mainly
India has an ancient heritage of traditional medicine.
includes acute tubular necrosis that commonly
material medica of India provide lots of information
accounts for 85% of incidence. Mostly acute tubular
on the folklore practices and traditional aspect of
necrosis occurs either due to ischemia or toxins. The
therapeutically important natural products. Indian
toxins may be exogenous or endogenous. The
traditional medicine is based on various systems
exogenous agents are radio contrast agents,
including ayurveda, sidda and unani. The evaluation
cyclosporine, antibiotics, chemotherapeutic agents,
of these drugs is mostly based on phytochemical,
organic solvents, acetaminophen and illegal
pharmacologically and allied approaches including
abortifacients5,6. Chronic renal failure (CRF) is an
various instrumental techniques like chromatography,
irreversible deterioration in the renal function which
microscopy and common thread running through
classically develops over a period of years, leading to

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loss of excretory metabolic and endocrine functions. Plumbago zeylanica L. is a medicinal plant greatly
Various causes of renal failure has been recognized valued in Ayurveda and it has Nephroprotective, anti-
like hypertension, diabetes mellitus, antineoplastic inflammatory, anti-diabetic, anti-cancer and
agents like cyclophosphamide, vincristin and cisplatin antihyperlipidemic activities.
etc.5,8. Rajakrishnan et al. (2017) had studied the protective
The source of nephro protective agent Demands of effect of hydroalcoholic extract of this plant extract in
herbal medicines are increasing as they are getting cisplatin induced nephrotoxicity in Swiss albino mice
more recognition for being cheaper and without any model. They found that the hydroalcoholic extract of
side effects. Medicinal plants are used in both P zeylanica produced significant reversal of cisplatin
developed and developing countries. Studies have induced kidney damages as indicated by measured
been carried out on adopting newer measures of biochemical parameters at higher dose of 400 mg/kg
preventing cisplatin side effects at tumoricidal doses b.w (Rajakrishnan et al. 2017). Aloe vera has been
towards attenuation of Nephrotoxicity, nephrotoxicity used for medicinal purposes in several countries
and others so as to save the lives of millions of cancer including Greece, Egypt, India, Mexico, Japan and
patients (Mora et al. 2003). China. Researchers proved that the aqueous leaf
extract of Aloe barbadensis has nephroprotective
A numbers of adjuvants and supplements are being
effect on gentamicin and cisplatininduced
tried to limit the toxicity of these drugs. Many herbs
nephrotoxicity in wistar rat model.
have been proven to be effectual as nephroprotective
agents, while many more are claimed to be Kumar et al. (2011) investigated about the pre-
nephroprotective but lack any such scientific evidence treatment of aqueous extract of Boerhaavia diffusa
to support such claims. Works so far carried out on root in repeated dose against acetaminophen
nephrotoxicity due to the ill effects of nephrotoxic rats for 14 days. Histopathological and
chemotherapeutic drugs as well as the stimulation of biochemical changes showed that the extract is potent
activity of drugs leading to the pronounced apoptosis against acetaminophen caused damages to kidneys
having lesser toxicity are quite scanty. Azima like tubular necrosis.
tetracantha is an ancient medicinal plant used in Few other medicinal plants such as Pimpinella
Siddha and Ayurvedic systems of medicine. It is tirupatiensis (Apiaceae family), Indigofera barberi,
proved by scientific study that the ethanol root extract Aegle marmelos and Tectona grandis also proved to
of A. tetracantha is found to have nephroprotective have significant nephroprotectivity in animal models
effect in glycerol-induced acute renal failure in wistar (Chatterjee et al. 2014, Surendra et al. 2011). The
albino rat model. The root extract is found to have nephroprotective activity is probably due to the
significant protective effect at 500 mg/kg body presence of flavonoids in all few herbal plants and for
weight. The phytochemical constituents such as their antioxidant properties as described by many
flavonoids, terpinoids, tannins, glucosinolate and studies. The results of all this study indicate that plant
saponins are present in this medicinal plant which extracts of some medicinal plant have good potentials
possibly responsible for the antioxidant, anti- for use in renal disease. Thus we can explore some
inflammatory, vasodilatory and diuretic activity (Rao other ethanomedicinal plants against experimentally
et al. 2016). induced nephrotoxicity.
Croton zambesicus is a famous ornamental plant
LITERATURE SURVEY
grown in villages and towns in Nigeria and this Chandrashekhar CH et al., (2008) were evaluated
species is widely spread in tropical Africa. The roots the anthelmintic activity of the bark extract of Ficus
are used as antimalarial, febrifuge and antidiabetic racemosa using adult earth warms. The bark extract
agent. Scientist proved that the ethanol extract of root of this plant has exhibited dose- dependent inhibition
part of C. zambesicus protects against gentamicin- of spontaneous motility (paralysis) response. The
induced kidney toxicity when treated as an adjuvant anthelmintic effect was compared with the effects
along with the anticancer drug (Jude et al. 2011). produced by the standard anthelmintic drug 3%
Murraya koenigii comes under the family Rutaceae piperazine citrate.
and commonly known as Curry leaf plant is Abu Hassanat at al., (2011) were evaluated the
traditionally a highly valued plant. It is used in many hypoglycemic and in vitro antioxidant activity of
ways for its medicinal value and characteristic aroma. ethanol extracts of this plant. Diabetes was induced in
Studies showed that M. koenigii extract is potent Swiss albino mice with the administration of alloxan.
against nephrotoxicity caused by Cyclophosphamide, At a dose of 100mg/kg the extract has shown
which is a widely used anticancer drug but it causes significant decrease in blood sugar level when
nephrotoxicity (Patel et al. 2017).

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compared to the alloxan induced diabetic mice. The and alloxan-induced diabetic rats. The doses
antioxidant potential of the extract was also studies by examined (200 and 400 mg/kg p.o.) exhibited
using DPPH free radical scavenging activity and significant hypoglycaemic activity in both
reducing property of ascorbic acid. experimental animal models when compared with the
Abu Hassanat, at al., (2011): studied the antioxidant control group.
potential of the Ficus racemosa fruit extract. Jaykaran et al., (2009) were studied the acute
Hypolipidemic activities of ethanolic extract Ficus toxicity study of an aqueous extract of Ficus racemosa
racemosa bark extracts were studied in alloxan Linn. bark in albino mice. Albino mice of either sex
induced diabetic rats. Oral administration of FrEBet were divided into four groups 1st group given plain
(300mg/kg bw) to diabetic rats restored the status of water and 2nd,, 3rd, 4th given 100,300 and 1000mg of
blood glucose, lipids and lipoproteins to near normal aqueous extract of herb per 100 gm body weight in
range. This investigation thus shows that FrEBet has single dose. After 72 h of dose blood sample taken to
potent antidiabetic and hypolipidemic effects in determine haemoglobin, RBC count, WBC count,
alloxan-induced diabetic rats and these effects were blood urea, blood glucose, serum Creatinine, serum
much comparable to that of the standard reference cholesterol, S.G.P.T and S.G.O.T. Result indicated
drug, glibenclamide`. that aqueous extract of Ficus racemosa did not have
Faiyaz Ahmed, et al., (2010) were studied the lethal effect upon 100 times of the therapeutic dose in
albino mice.
anticholinesterase activities of cold and hot aqueous
extracts of F. racemosa stem bark. This study was Faiyaz Ahmed et al., (2010) were found that the
evaluated the anticholinesterase activity of cold and Ficus racemosa bark is a good source of dietary fiber,
hot aqueous extracts of Ficus racemosa stem bark minerals, sugars and phenolic compounds. On dry
against rat brain acetylcholinesterase in vitro. Both basis, the total dietary fiber content was 20.5% of
the cold aqueous extract and the hot aqueous extract which major portion was contributed by insoluble
exhibited a dose dependent inhibition of rat brain dietary fiber (13.6%). Potassium was the most
acetylcholinesterase. abundant mineral (11975 ppm) followed by chloride
(7475 ppm) and calcium (1729 ppm). The bark was
Ahmed F et al., (2009) were studied the glucose-
also a good source of other minerals and trace
lowering, Nephroprotective and hypolipidemic
elements such as phosphorus and iron, zinc,
activities of stem bark of Ficus racemosa in
magnesium, respectively.
streptozotocin-induced diabetic rats. The study was
evaluated the antihyperglycemic, Nephroprotective, Veerapur V.P. et al., (2007) were reported the
and hypolipidemic effects of F. racemosa bark antioxidant activity of ethanol extract and water
powder and aqueous extract in streptozotocin-induced extract of Ficus racemosa bark. These extracts were
diabetic rats. Both the bark powderand aqueous subjected to free radical scavenging both by steady
extract of F. racemosa bark caused a significant state and time resolved methods such as nanosecond
reduction (P ≤ 0.05) in blood glucose (54 and 66% pulse radiolysis and stopped-flow spectrophotometric
respectively). analyses and based on the obtained results, concluded
Ahmed F et al., (2010) were reported the that the ethanol extract of F. racemosa acts as a potent
antibacterial activities of various sequential extracts antioxidant and a probable radioprotector.
of Ficus racemosa stem bark. The was study Ahmed F. et al., (2010) were studied the
evaluated the antibacterial activity of sequential Nephroprotective effects of petroleum ether and
extracts of Ficus racemosa stem bark against methanol extract of Ficus racemosa Linn. stem bark.
Staphylococcus aureus, Bacillus cereus, They were studied using the model of Nephrotoxicity
Pseudomonas aeruginosa, Escherichia coli and induced by CCl4 in rats. The CCl4 administration
Bacillus subtilis by disk-diffusion and agar- diffusion induced a significant decrease in serum total protein,
methods. In disk-diffusion assay chloroform, acetone albumin, urea and a significant increase (P ≤ 0.01) in
and methanol extracts showed moderate antibacterial total bilirubin associated with a marked elevation in
against Staphylococcus aureus, Bacillus cereus, the activities of aspartate aminotransferase (AST),
Bacillus subtilis compared to the control,while alanine aminotransferase (ALT) and alkaline
petroleum ether extract did not exhibit antibacterial phosphatase (ALP) as compared to control rats.
activity against any of the organisms tested. <<
Bhaskara Rao B et al., (2002) were evaluated the Ranasooriya WD et al., (2003) were reported the
glucose-lowering efficacy of a methanol extract of the antidiuretic activity of the bark of Ficus racemosa
stem bark of Ficus racemosa Linn. both in normal Linn. The results demonstrated both the low- and

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high-doses of bark decoction (D) and ADH [5] Herfindal, Gourley. Text book of therapeutic
significantly impaired the total urine output. The D- drug and disease management. 7th Edn. Charcil
induced antidiuresis had a rapid onset (within 1 h), Livingstone, London; 2000; 425- 36.
peaked at 3 h and lasted throughout the study period [6] Barry M, Brenner, Floyd C, Rector. The kidney
(5 h). However, antidiuretic potential of D was about 6th Ed. Vol I, W. B. Saunders Company,
50% lower than that of ADH. The results provide Philadelphia; 2000; 3-67
scientific support for its claimed antidiuretic action
and deserve intensive scrutiny. [7] Schrier RW, Gottschalk CW. Disease of
kidney, 5thed, 2, Published by Little Brown &
Mohammed Safwan Ali Khan, et al., (2011) were Co, 1993; 1031-1165.
evaluated the antiulcer activity of Ficus raligiosa
against indomethacin and cold restrained stress- [8] Baumann, K and Hannemann. J. Toxicology,
induced gastric ulcer and pylorus ligation assays. The 1988; 51: 119- 132.
extract (100, 200 and 400 mg/kg) significantly [9] Mora L. D., Antunes L. M., Francescato H. D.,
(P<0.05) reduced the ulcer index in all assays used. In Bianchi M. del., The effects of oral glutamine
conclusion, the present study provide preliminary data on cisplatin-induced nephrotoxicity in rats.
on the antiulcer potential of F. religiosa stem bark and Pharmacol. Res. 2003; 47: 517–522
support the traditional uses of the plant for the
treatment of gastric ulcer. [10] Rao V, Arunachalam R, Madhavi Eerike a,
Ramesh Rao K b, Arun Kumar Radhakrishnan
Kaiser Hamid et al., (2011) were evaluated the free a, Lakshmipathy Prabhu Raghuraman a,
radical scavenging activity of Ficus racemosa seeds Vinayak Meti a, Sobita Devi, Nephroprotective
using DPPH and brine shrimp lethality bioassay effect of ethanolic extract of Azima tetracantha
method. In both the methods, Ficus racemosa showed root in glycerol induced acute renal failure in
a significant activity. Wistar albino rats. Journal of Traditional and
DISCUSSION Complementary Medicine. 2016; 6: 347- 354.
Herbal medicine is globally accepted as a alternative [11] Jude E. O., Paul A, Noah K. Nephroprotective
system of therapy in the pharmaceuticals. But the effect of Croton zambesicus root extract against
drug delivery system for herbal drugs is quite gentimicin-induced kidney injury. Asian Pacific
traditional and out of date. An extensive research is Journal of Tropical Medicine. 2011; 10: 969-
going on in the area of novel drug delivery and 972.
targeting for plant actives and extracts. However,
research in this area is still at the exploratory stage. A [12] Patel M, Singh P. Nephroprotective effect of
number of plant constituents like flavonoids, tannins, Murraya koenigii on cyclophosphamide
terpenoids etc. showed enhanced therapeutic effect at induced nephrotoxicity in rats. Asian Pacific
similar or less dose when incorporated into novel Journal of Tropical Medicine. 2017; 10(8):
drug delivery vesicles as compared to conventional 808–812
plant extracts. Hence, there is a need in development [13] Rajakrishnan R, Lekshmi R, Benil C, Thomas
of novel drug delivery system for valuable herbal J, AlFarhan A, Rakesh V, Khalaf S.
drugs as it provides efficient and economical drug Phytochemical evaluation of roots of Plumbago
delivery. Also, the trend of incorporating NDDS for zeylanica L. and assessment of its potential as a
herbal drugs has also been adopted at industrial scale. nephroprotective agent, Saudi Journal of
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