Salvianolic Acids and Their Pharmacological Promise in Kidney Diseases: A Narrative Review.

Kidney disease is a major public health challenge, affecting millions of people worldwide. Conventional treatments often produce suboptimal outcomes and are associated with various adverse effects. Traditional Chinese Medicine has shown promising therapeutic potential, offering distinct advantages over conventional therapies for preventing and treating kidney diseases. Salvianolic acids, the principal bioactive constituents of Salvia miltiorrhiza, are widely used in the management of renal disorders. However, no dedicated review has systematically synthesized pharmacological evidence across different models of kidney disease. To advance both basic research and clinical applications, this review summarizes current knowledge on the therapeutic effects of salvianolic acids in acute kidney injury, diabetic kidney disease, and nephrotic syndrome. Their renoprotective actions arise from the modulation of multiple pathological processes, including inflammation, oxidative stress, apoptosis, mitochondrial dysfunction, endoplasmic reticulum stress, and autophagy dysregulation. Collectively, salvianolic acids hold promise as potential therapeutic agents for kidney diseases. Further studies are needed to confirm these molecular mechanisms and identify specific targets. Additionally, large-scale, long-term, multicenter clinical trials are crucial to evaluate the efficacy and safety of salvianolic acids in treating kidney diseases.