Natural Products as Potential Therapeutic Candidates for Diabetic Kidney Disease: Molecular Mechanisms, Translational Challenges, and Future Prospects

Diabetic Kidney Disease (DKD) is one of the primary causes of chronic kidney disease. However, existing clinical interventions remain insufficiently effective in halting its progression, highlighting the need to explore novel therapeutic approaches. In recent years, natural products such as Abelmoschus manihot have shown growing potential in lowering urinary protein. Building on this background, this paper systematically summarizes preclinical evidence that certain natural substances ameliorate DKD by targeting key pathogenic mechanisms, including inflammation and oxidative stress. It also contrasts the pros and cons of natural medicines with existing therapies, while further investigating advanced pharmaceutical technologies for the translation of natural medicines into clinical applications. However, the clinical translation of natural medicines currently confronts multiple challenges, including small sample sizes, insufficient follow-up periods, individual heterogeneity, and insufficient accumulation of safety data. Therefore, future efforts should prioritize the in-depth exploitation of medicinal plant resources and their clinical translation, with a focus on enhancing high-quality translational clinical studies. This strategy seeks to provide novel insights and practical solutions for treating DKD.