Evaluating the safety of common herbal supplements in chronic kidney disease, dialysis, and kidney transplant patients

1. Which of the following herbal supplements’ use could be considered in dialysis patients, although with extreme caution and careful monitoring? (Select all that apply)

2. Purely from a safety perspective, which of these herbal supplements would you recommend for a patient with stage 4 CKD?

3. A patient with stage 5 CKD that has not started on dialysis yet ingests an excessive amount of echinacea over a 1-month period. This patient would expect to encounter what kidney complications? (Select all that apply)

4. What risks could a dialysis patient who takes glucosamine and noni juice encounter?

5. Which herbal supplements can increase bleed risks?

6. Which of these below counseling points would one address with a patient who wants to start using St. John’s wort? This patient had a successful kidney transplant 14 days ago, is currently on intermittent hemodialysis, and takes tacrolimus.

7. What could happen in a kidney transplant patient on cyclosporine who starts to take St. John’s wort and echinacea for general health benefits? (Select all that apply)

8. This herbal supplement has many known drug interactions, providing a strong reason to avoid it in CKD, dialysis and kidney transplant patients who are likely to use multiple prescription medications:

9. What factors should one consider when determining if an herbal supplement is appropriate and safe for a CKD, dialysis or kidney transplant patient?

10. Which tools or resources would one use to find information on an herbal supplement to ensure it is safe for CKD patients to use?