Review of the Delay of Chronic Kidney Disease Progression by Wuling San on Improving Renal Fibrosis

Renal fibrosis is a common pathological process in chronic kidney disease (CKD), which is mainly characterized by glomerulosclerosis and tubulointerstitial fibrosis. The formation and development of renal fibrosis are stimulated by pro-inflammatory as well as pro-fibrosis factors released by inflammatory cells. Wuling San is an ancient Chinese classical formula for urination-promoting and dampness-draining, which can regulate the metabolism of water and fluid and has exerted therapeutic effects on various chronic kidney diseases by reducing oedema, inflammation, and improving glomerulosclerosis and renal interstitial fibrosis. However, further study is still needed to explore the mechanism. Based on the research analysis with the help of CiteSpace, the following three directions were the possible mechanisms in improving renal fibrosis: inhibiting the conversion of renal cells to myofibroblasts; regulating amino acid, lipid and energy metabolism and reducing extracellular matrix (ECM) deposition; and regulating the RhoA/ROCK pathway, the downstream of G protein-coupled receptor (GPCR). This review aims to summarize the mechanism of action of Wuling San in the treatment of CKD from the perspective of antifibrosis, which can help to explore the new ideas and directions of Wuling San in the treatment of renal diseases.