The effects of traditional Chinese botanical medicine on membranous nephropathy

Membranous nephropathy (MN), an autoimmune glomerulopathy driven by podocyte antigens, is a leading cause of end-stage renal disease (ESRD). However, its pathogenic mechanisms remain incompletely understood. This knowledge gap results in significant physical and psychological burdens for patients worldwide and poses substantial challenges for clinical management. Current conventional treatments for MN are often associated with significant side effects and may not yield satisfactory outcomes. Therefore, the development of more efficacious and better-tolerated therapeutic strategies for MN is imperative. Given these clinical challenges, Traditional Chinese Botanical Medicine (CHMs), with their multi-component and multi-target characteristics, have emerged as a promising alternative or complementary therapeutic approach for MN. This review aims to summarize the evidence on the mechanisms and clinical efficacy of CHMs and their active metabolites in treating MN, drawing from findings reported in animal experiments, clinical trials, systematic reviews, and meta-analyses. It seeks to elucidate the potential advantages of CHMs in MN management and to provide a reference for future research in this field. Study design and methods: For this review, the following major academic research databases were consulted: PubMed, ResearchGate, Science Direct, and Web of Science. "Glomerulonephritis, Membranous [MeSH Terms] OR Extramembranous Glomerulopathy [Text Word] OR Membranous Glomerulonephropathy [Text word] OR Membranous Nephropathy [Text word] OR Idiopathic Membranous Glomerulonephritis [Text word]OR Glomerulonephritides, Idiopathic Membranous. [Text word])," "(Medicine, Chinese Traditional [MeSH Terms] OR Medicine, Chinese Traditional [Text Word] OR Medicine, Chinese Traditional [Text word] OR Tongue Diagnosis, Traditional [Text word] OR Traditional Tongue Assessment [Text word]," "Drugs, Chinese Herbal [MeSH Terms] OR Chinese Drugs, Plant [Text Word] OR Chinese Herbal Drugs [Text word] OR Plant Extracts, Chinese [Text word] OR Chinese Plant Extracts [Text word]," "mechanism," "Meta-analysis," "systematic review," "RCT," "botanical drug" and their combinations were the keywords to search the relevant literature. Data were collected from 2019 to 2025.