El uso de suplementos botánicos y la enfermedad renal.
El Control de Líquidos en Personas en Diálisis
31 marzo, 2016
¿Cómo Explicarles a los Niñ@s la Importancia de Mantener la Dieta Renal en el Manejo de la Condición de Salud?
4 abril, 2016El uso de suplementos botánicos y la enfermedad renal.
Por Carla Fabián González, LND, MHSN
El uso de suplementos dietarios ha ido aumentando a través de los años. Muchas veces su consumo se debe a la búsqueda de un método alternativo para mejorar algún signo o síntoma y no de tratar o curar una enfermedad1. Los suplementos dietarios son productos utilizados para complementar la alimentación y pueden contener vitaminas, minerales, hierbas y otras sustancias que pueden ser administradas por boca en forma de pastilla, polvo, gel o líquido2.
Los suplementos botánicos se han ido popularizando cada vez más. Un botánico es una planta o partes de una planta que se caracteriza por sus propiedades medicinales o terapéuticas2. Las hierbas son un subgrupo de éste. Sin embargo, muchas personas piensan que al ser un producto natural su uso es seguro. Esta aseveración no necesariamente es cierta ya que va a depender de la composición química de la hierba, cómo funciona en el cuerpo, y cómo se debe preparar y utilizar.
Estudios han demostrado que algunos suplementos dietarios (incluyendo los botánicos) pueden tener interacción con los medicamentos3 lo que podría afectar la efectividad de éste, como por ejemplo el rechazo de un trasplante de riñón1. Inclusive, investigaciones han señalado que el uso de ciertos suplementos botánicos puede aumentar el riesgo de desarrollar enfermedad crónica del riñón4 y fallo del riñón5. Sin embargo, la importación de estas hierbas, conocidas como Mu Tong y Fangi (ambas con el componente Aristolochia), ha sido prohibida en Europa y Estados Unidos debido a su toxicidad6. A continuación se detallan algunas de las hierbas (botánicos) más comunes, sus usos y sus precauciones.
Tabla 1. Hierbas (botánicos): uso y precauciones1,7
|
Hierba |
Uso común |
Evidencia científica |
Efectos secundarios |
Uso en personas con enfermedad renal |
| Ajo (Allium sativum) | Enfermedad del corazón, bajar la presión arterial | Leve disminución en niveles de colesterol alto y presión arterial alta | Mal aliento, acidez, dolor abdominal, gas, reacción alérgica; puede reducir la coagulación de la sangre | Contraindicado si es utilizado por largos periodos de tiempo por el potencial a aumentar sangrados y disminuir la presión arterial |
| Camomila (Matricaria recutita) | Ansiedad, gases, diarrea, dolor de barriga, insomnio | No hay suficiente evidencia que confirme sus beneficios | Cuando se toma con ciertos medicamentos puede causar somnolencia, aumentar el riesgo de sangrado, aumentar azúcar en sangre y aumentar la presión arterial | Contraindicado por el potencial a aumentar sangrados, niveles de azúcar en sangre y presión arterial por interacción con ciertos medicamentos |
| Gingko (Ginkgo biloba) | Tinnitus (zumbidos en el oído), demencia, claudicación (dolor de pierna por arterias estrechas) | Leve disminución en el dolor de piernas, no disminuye la incidencia de demencia o mejora la memoria | Dolor de cabeza, náuseas, diarrea, mareos; puede aumentar riesgo de sangrado cuando se toma con ciertos medicamentos y afectar los niveles de azúcar e insulina; consumir las semillas puede causar convulsiones o hasta la muerte | Contraindicado por el potencial a aumentar sangrados por interacción con ciertos medicamentos |
Cont. Tabla 1. Hierbas (botánicos): uso y precauciones1,7
|
Hierba |
Uso común |
Evidencia científica |
Efectos secundarios |
Uso en personas con enfermedad renal |
| Ginseng (Panax ginseng: Panax spp.) | Enfermedades del corazón, diabetes | Parece tener antioxidantes que benefician a personas con condiciones del corazón; puede bajar niveles de azúcar en sangre en la diabetes tipo 2 y aumentar el sistema inmunológico | Erupciones en la piel, picazón, diarrea, pérdida de apetito, garganta irritada, ansiedad, insomnio; puede subir o bajar la presión arterial, aumentar riesgo de sangrado e interactuar negativamente cuando se toma con ciertos medicamentos o suplementos | Contraindicado por el potencial a aumentar sangrados por interacción con ciertos medicamentos |
| Linaza o aceite de linaza (Linum usitatissimum) | Laxante, dolor de pecho, disminuir colesterol alto y prevenir el cáncer | La semilla puede tener efecto laxativo por su contenido de fibra soluble; no hay suficiente evidencia que confirme beneficio para bajar el colesterol y prevenir el cáncer | Diarrea; debe tomarse con mucha agua, pues puede empeorar los problemas de estreñimiento; por su contenido de fibra puede disminuir la absorción de medicamentos tomados por boca; no indicado en personas con síndrome de intestino irritado, diarrea, diverticulitis, obstrucción intestinal | Contraindicado por la necesidad de ingerir grandes cantidades de agua (pacientes con enfermedad en los riñones usualmente tienen restricción de líquidos) y por la falta de evidencia científica que demuestre su efectividad |
| St. John’s Wort (Hypericum perforatum L.) | Depresión, ansiedad | Se dice ser efectivo a corto plazo en personas con depresión leve. | Boca seca, incomodidad gastrointestinal, dolor de cabeza; se ha reportado que puede causar pensamientos suicidas u homicidas; interfiere con el modo en que el cuerpo utiliza ciertos medicamentos, incluyendo inmunosupresores, antidepresivos, anticonceptivos, antibióticos | Parece ser seguro cuando se toma en las cantidades recomendadas, sin embargo, no debe ser utilizada por personas con trasplante de riñón que estén tomando inmunosupresores por posible rechazo a éste |
| Té verde (Camellia sinensis) | Pérdida de peso, bajar niveles altos de colesterol, mantenerse despierto | Se dice que ayuda a la persona a mantenerse despierto debido a su contenido de cafeína; no hay suficiente evidencia que confirme su beneficio para bajar colesterol y de peso | Insomnio, ansiedad, irritabilidad, agente diurético (pérdida de agua), problemas gastrointestinales, aumento en la presión arterial y latidos del corazón; el uso excesivo puede llevar a la dependencia | Parece ser seguro cuando se toma en las cantidades recomendadas, sin embargo, puede tener interacción con la efectividad de varios medicamentos por su contenido de cafeína |
Antes de comenzar a utilizar algún suplemento dietario, consulte a su médico o nutricionista para que le oriente. Si desea adquirir más información puede visitar la página del Centro Nacional de Salud Integral y Complementaria de Estados Unidos (https://nccih.nih.gov).
Referencias:
- Byham-Gray L, Stover, J, Wiesen K. A Clinical Guide to Nutrition Care in Kidney Disease. 2 nd ed. Chicago, Ill: American Dietetic Association; 2013. ISBN: 9780880914703
- US Department of Health and Human Services. Office of Dietary Supplements. https://ods.od.nih.gov. Accesado el 2 de marzo de 2016.
- Tsai HH, Lin HW, Pickard AS, et al. Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review. Journal of Clinical Practice, 2012; 66 (11): 1056-78.
- Wen CP, Cheng TYD, Tsai MK, et al. All-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462293 adults in Taiwan. Lancet, 2008; 371 (9631): 2173-82.
- Ming-Nan L, Jung-Nien L, Pau Chung C, et al. Risks of kidney failure associated with consumption of herbal products containing mu tong or fangchi: a population-based case-control study. American Journal of Kidney Diseases, 2010; 55 (3): 507-18.
- Upton R, Graff A, Jolliffe G, et al. American herbal pharmacopoeia: botanical pharmacognosy- microscopic characterization of botanical medicines. FL: CRC Press; 2011.
- US National Center for Complementary and Integrative Health. Herbs at a glance. https://nccih.nih.gov. Accesado el 2 de marzo de 2016.
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