Traditional Chinese medicine in the treatment of diabetic kidney disease: the mechanisms of signaling pathways regulations

Diabetic kidney disease (DKD) represents a diabetes-driven microvascular complication characterized by renal physiological and metabolic disorders and is considered a top-ranking trigger of progression to end-stage renal disease and death in diabetic patients. Although the drugs commonly used in clinical practice for DKD provide some renal protection, their toxic side effects and limited ability to halt further progression of the disease remain unsatisfactory. Traditional Chinese medicine (TCM) brings centuries of accumulated practice and distinct therapeutic strengths to the management of chronic diseases with complex pathogenesis such as DKD. Its characteristics of multi-target and multi-pathway intervention establish a solid material basis for DKD therapy, while its low toxicity profile aligns well with the chronic nature of DKD. This review elaborates on the therapeutic potential of examining TCM's impact on DKD through the prism of cellular signaling pathways and reveals that the Nrf2, TGF-β/Smad, NF-κB/NLRP3, MAPK, and PI3K/AKT signaling pathways warrant particular attention in the TCM treatment of DKD. The TCM agents involved include astragaloside IV, Shengqing Jiangzhuo formula, Huangkui capsule, Fuxin granules, Liuwei Dihuang pill, Taxus chinensis, Burdock fructooligosaccharide, baicalin, hirudin, rutin, and fermented seaweed extracts. This review aims to refresh and consolidate the signaling pathways engaged by TCM in DKD, sift for promising targets and drugs, and supply both conceptual and experimental scaffolding for future anti-DKD therapeutics.

Resumen tomado de PubMed (NCBI) para el registro citado, en el idioma original. La versión de referencia es la de la publicación original.

El resumen se deja sin traducir para conservar la redacción original de los autores.

This review covers traditional Chinese medicine agents — including hirudin, astragaloside IV, baicalin and rutin — in diabetic kidney disease, focusing on the Nrf2, TGF-β/Smad, NF-κB/NLRP3, MAPK and PI3K/AKT signaling pathways.

Explore cómo esta investigación se conecta con la práctica clínica

Más estudios revisados por pares en la categoría «Farmacología salival».

• Novel Leech Antimicrobial Peptides — Hirunipins — Kumar et al. (2025)
• Leech Salivary Proteome and Transcriptome: 434 Deduced Protein Sequences — Liu Z, Tong X, Su Y, et al. (2019)
• Medicinal Leech Draft Genome — Anticoagulant Gene Survey — Kvist S, Manzano-Marín A, de Carle D, Trontelj P, Siddall ME (2020)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• Efficacy and Safety of Hirudotherapy for Improving Sperm Quality Parameters in Male Infertility: A Randomized Controlled Trial — Abtahi-Forooshani M et al. (2026)
• Medicinal leeches and hirudotherapy — Gödekmerdan A et al. (2011)
• PEROXIDATION OF SALIVA LIPIDS IN PATIENTS WITH POSTCOVID SYNDROME DURING HIRUDOTHERAPY — Serikbayeva S et al. (2024)
• Medicinal leech therapy in pain syndromes: a narrative review — Koeppen D, Aurich M, Rampp T (2014)
• Leech therapy in the treatment of a penile haematoma in a stallion — Nowicki A, Jaworska J, Baranski W (2021)
• Leech therapy (Hirudo medicinalis) attenuates testicular damages induced by testicular ischemia/reperfusion in an animal model — Davoodi F et al. (2021)

Ver toda la investigación analizada por la ASH →