The Renoprotective Effects of Radix Astragali and Salvia miltiorrhiza Bunge on Short-Term Outcomes of Acute Kidney Injury: A Retrospective Study

Background: Acute kidney injury (AKI) is a significant global health challenge. It directly impairs patient quality of life and can lead to the development of chronic kidney disease (CKD). Recent evidence suggests that herbal medicines, such as Radix Astragali (RA) and Salvia miltiorrhiza Bunge (SM), may have renoprotective activity against AKI. Given that previous studies have mainly focused on in vitro experiments, we conducted a retrospective study to determine whether the use of RA and SM can provide short-term benefits to patients with AKI and prevent progression to CKD. Methods: The study included patients diagnosed with AKI at the Guangdong Provincial Hospital of Chinese Medicine between January 1, 2012, and December 31, 2022. Patients with the following conditions were excluded: preexisting CKD, AKI diagnosed less than 24 h or more than 120 days prior to the study, or incomplete baseline data. Univariate and multifactor logistic regression analyses were conducted to assess the impact of RA and SM on short-term outcomes of patients with AKI. Results: Treatment with an herbal decoction (relative risk [RR] = 2.981, 95% confidence interval [CI] [1.970, 4.509]), hemoglobin level (RR = 1.009, 95% CI [1.005, 1.012]), and admission to the intensive care unit (RR = 1.552, 95% CI [1.232, 1.954]) were positively associated with short-term recovery from AKI, while a history of operation before AKI (RR = 0.318, 95% CI [0.195, 0.517]) and hypertension (RR = 0.767, 95% CI [0.616, 0.953]) were negatively associated with short-term recovery from AKI. Importantly, the use of RA (RR = 1.610), SM (RR = 1.350), RA or SM (RR = 1.697), and a combination of RA and SM (RR = 1.368) were found to facilitate short-term recovery from AKI to a significant degree in the multivariate analysis. Conclusion: In this study, the use of RA and SM increased the rate of short-term recovery from AKI and potentially prevented progression to CKD. These findings suggest that herbal medicines offer a promising approach for the management of AKI and warrant further investigation.