Published Paper Details:

Gentamicin, a widely prescribed aminoglycoside antibiotic, is highly effective against severe Gram-negative bacterial infections; however, its clinical utility is significantly limited by its nephrotoxic potential. Gentamicin-induced renal injury primarily affects proximal tubular epithelial cells and is mediated by complex, interrelated mechanisms, including excessive generation of reactive oxygen species, mitochondrial dysfunction, lysosomal phospholipidosis, release of inflammatory cytokines, and activation of apoptotic pathways. Despite dose adjustment and therapeutic drug monitoring, the incidence of gentamicin-associated nephrotoxicity remains substantial, particularly in elderly patients and those with pre-existing renal impairment or polypharmacy. This review explores the molecular and cellular mechanisms of gentamicin-induced kidney damage and highlights recent research on Polyherbal remedies with potential nephroprotective effects. Evidence suggests that formulations containing flavonoids, phenolics, tannins, and terpenoids may protect the kidneys by enhancing antioxidant defences, reducing inflammation, maintaining cell membrane stability, and modulating proteins involved in cell death, such as Bcl-2 and caspases. Polyherbal remedies may be more effective than single-compound treatments because they target multiple pathways involved in kidney injury. This review highlights the potential of combining traditional herbal medicine with modern nephrology research to develop safer treatments for drug-induced kidney injury. While early results are promising, challenges remain in standardizing remedies, ensuring quality, understanding pharmacokinetics, and proving clinical efficacy. Future research should focus on rigorous clinical trials to confirm the effectiveness of polyherbal remedies. These formulations may complement current therapies to prevent gentamicin-induced kidney damage and improve the safety of gentamicin use.