Research on the Major Active Constituents of Astragalus Membranaceus for the Treatment of Diabetic Kidney Disease

This paper systematically reviews recent domestic and international research on diabetic kidney disease over the past three years. Starting from novel pathogenic mechanisms, This review demonstrates that ferroptosis in renal tubular epithelial cells, long-term low-level inflammation driven by the inflammatory protein complex NOD-like receptor pyrin domain-containing protein 3 (NLRP3), and gut-kidney axis imbalance are three core mechanisms driving diabetic kidney disease progression. Astragalus membranaceus, a traditional Chinese medicine, can specifically regulate renal metabolic disorders, inflammatory responses, and gut microbiota balance, thereby effectively inhibiting renal tissue fibrosis. To slow renal function decline, this paper explains how different active ingredients in Astragalus membranaceus act on ferroptosis, the NLRP3 inflammasome, and the gut-kidney axis, respectively, and summarizes differences in the efficacy of each active ingredient and the synergistic effects of combined use. Finally, the current research limitations are objectively analyzed, and possible future directions for research on mechanisms of action and clinical applications are also pointed out.