Phytochemistry and multi-target pharmacological mechanisms of Abelmoschus manihot (L.) Medicus in diabetic nephropathy

Diabetic nephropathy is a leading cause of end-stage renal disease, but current therapies remain limited in efficacy and safety. Abelmoschus manihot (L.) Medicus possess kidney protecting effects in traditional Chinese medicine. Modern clinical practice has used its standard preparation Huangkui capsules to treat kidney diseases and confirmed flavonoids are main active ingredients. This review provides a comprehensive overview of the phytochemical profile of A. manihot, with emphasis on flavonoids, and systematically summarises their multi-target pharmacological mechanisms in DN, including anti-inflammatory, anti-oxidant, anti-fibrosis and cytoprotective effects. Additionally, the structural characteristics of the compounds also describe in this article, providing a chemical rationale for the development of flavonoid-based therapeutics against this complex disease.