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Nephroprotective Effects of Silymarin: A Systematic Review and Meta-Analysis
Negin Frounchi1, Fariba Mahmoodpoor1,2, Seyed Sina Zakavi3
1Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, 51665118, Iran.
Biochemistry. Biokhimiia
|August 31, 2025
Summary
Silymarin, a milk thistle flavonoid, may protect kidneys by lowering serum creatinine levels, particularly in drug-induced acute kidney injury. Further research is needed due to study limitations.
Area of Science:
- Pharmacology and Toxicology
- Nephrology
- Natural Product Chemistry
Background:
- Kidney dysfunction poses significant patient and societal burdens, necessitating novel nephroprotective agents.
- Silymarin, a flavonoid from milk thistle, exhibits antioxidant and anti-inflammatory properties with potential nephroprotective benefits.
Purpose of the Study:
- To systematically review and meta-analyze clinical trials on silymarin's nephroprotective effects.
- To evaluate silymarin's impact on serum creatinine levels in patients with kidney dysfunction.
Main Methods:
- Systematic review of Scopus, PubMed, and Web of Science databases, excluding animal or cell studies.
- Meta-analysis of 7 clinical trials assessing serum creatinine changes.
- Subgroup analysis based on silymarin dosage, treatment duration, patient age, and kidney disease type; ROB2 tool for quality assessment.
Main Results:
- Meta-analysis revealed a significant reduction in serum creatinine levels with silymarin (Hedges' g, -1.23; p=0.0024).
- A significant creatinine reduction was observed in patients with drug-induced acute kidney injury (AKI) (p=0.003).
- No significant effect was found in patients with chronic kidney disease (CKD) (p=0.3065) or with a 280 mg daily dose (p=0.2375).
Conclusions:
- Silymarin administration may offer a nephroprotective effect in drug-induced AKI by reducing serum creatinine.
- The effectiveness of silymarin appears dependent on the type of kidney injury.
- Limitations include a small number of analyzed articles and heterogeneity, warranting further investigation.
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