Diabetic Nephropathy is one of the major microvascular complications of Diabetes Mellitus, which can be detected in the earlier stage by investigating urinary microalbumin excretion levels and estimating ACR and GFR. Early treatment can delay or prevent the progression of diabetic Nephropathy. Monoherbal Siddha formulation Sirupeelai Kudineer indicated for the complications of Diabetes Mellitus is selected for this Case study. The efficiency of the drug was assessed by measuring the change in renal function throughout the treatment period and the KD QOL assessment. Four patients presented with symptoms of Diabetic Nephropathy were treated with the monoherbal Siddha formulation Sirupeelai Kudineer. This series of four cases showed improvement in CKD QOL and some biochemical parameters. Blood urea was reduced in the four cases during medication. Serum creatinine levels mildly increased in three cases somewhere during the treatment period but decreased in all four cases after treatment. The estimated GFR also improved in three cases after treatment but mildly reduced in one patient. Symptomatic improvement was also observed in all the patients. Marked reduction in blood urea and serum creatinine levels after treatment shows the Nephroprotective action of the drug. The clinical and laboratory parameters observed among these four patients suggest that this drug may be used along with other hypoglycemic drugs to treat Diabetic Nephropathy.

Modern treatment interventions for kidney stones are wrought with side-effects, hence the need for alternative therapies such as plant-based medicines. We have previously documented through in vitro studies that statistically optimized aqueous extract of Tribulus terrestris (Zygophyllaceae family) possesses antiurolithic and antioxidant potential. This provides strong scientific foundation to conduct in vivo efficacy and preclinical safety studies to corroborate and lend further proof to its ability to prevent and cure kidney stones. The preventive and curative urolithiatic efficacy in experimentally induced nephrolithiatic Wistar rats, along with preclinical toxicity was evaluated following oral administration of statistically optimized aqueous extract of T. terrestris. Treatment showed augmented renal function, restoration of normal renal architecture and increase in body weight. Microscopic analysis of urine revealed excretion of small sized urinary crystals, demonstrating that treatment potentially modulated the morphology of renal stones. Tissue enzymatic estimation affirmed the antioxidant efficacy of treatment with reduced free radical generation. Significant upregulation of p38MAPK at both the gene and protein level was noted in hyperoxaluric group and interestingly treatment reversed it. Acute oral toxicity study established the Median Lethal Dose (LD50) to be greater than 2000 mg/kg body weight (b.wt.) No observed adverse effect level (NOAEL) by repeated oral toxicity for 28 days at 750 mg/kg b.wt. was noted. This study lends scientific evidence to the safe, preventive and curative potential of statistically optimized aqueous extract of T. terrestris at a dose of 750 mg/kg b.wt. and suggests that the extract shows promise as a therapeutic antiurolithic agent.