Silymarin: A Potential Treatment for Diabetic Nephropathy

Diabetic nephropathy is the most common cause of kidney failure worldwide. In this month's AJKD, Fallahzadeh and colleagues investigate a new potential agent to treat diabetic nephropathy: silymarin, an herbal drug with antioxidant and anti-inflammatory properties. The authors performed a randomized, double-blind, placebo-controlled, clinical trial assessing the possible efficacy and safety of silymarin in addition to RAS inhibitors in patients with type 2 diabetes and overt nephropathy, demonstrating a significantly greater decrease in albuminuria in participants randomized to silymarin. In any accompanying editorial, Meyers and Briggs discuss both the valuable opportunities and unique challenges of using botanical products to treat diseases. The authors remind readers that, unlike conventional drugs, botanicals typically are mixtures of uncharacterized constituents, and particular attention must be placed on analysis of all potential active ingredients, as well as batch-to-batch variability—and, just as with many conventional agents, promising initial reports of botanical products often are not confirmed.