Diabetic nephropathy is the major cause of end-stage renal disease and effective and new therapeutic approaches are needed in diabetic nephropathy and chronic kidney diseases. Oxidative stress and inflammatory process are important factors contributing to kidney damage by increasing production of oxidants. KEAP1/Nrf2/ARE pathway regulates the transcription of many antioxidant genes and modulation of the pathway up regulates antioxidants. NFB controls the expression of genes involved in the inflammatory response. Natural substances have antioxidant and anti-inflammatory activities and have an impact on NFB and KEAP1/Nrf2/ARE pathways. The preclinical studies explored the effectiveness of whole herbs, plants or seeds and their active ingredients in established diabetic nephropathy. They ameliorate oxidative stress induced kidney damage, enhance antioxidant system, and decrease inflammatory process and fibrosis; most likely by activating KEAP1/Nrf2/ARE pathway and by deactivating NFB pathway. Whole natural products contain balanced antioxidants that might work synergistically to induce beneficial therapeutic outcome. In this context, more clinical studies involving whole plants or herbal products or mixtures of different herbs and plants and their active ingredients might change our strategies for the management of diabetic nephropathy. The natural products might be useful as preventive interventions and studies are required in this field.

糖尿病肾病是终末期肾病的主要原因，糖尿病肾病和慢性肾脏病需要有效的新治疗方法。氧化应激和炎症过程是通过增加氧化剂的产生而导致肾脏损伤的重要因素。KEAP1/Nrf2/ARE 通路调节许多抗氧化基因的转录，调节该通路可上调抗氧化剂。NFB 控制参与炎症反应的基因的表达。天然物质具有抗氧化和抗炎活性，并对 NFB 和 KEAP1/Nrf2/ARE 通路产生影响。临床前研究探讨了整个草药、植物或种子及其活性成分对已确诊的糖尿病肾病的有效性。它们可以改善氧化应激引起的肾脏损伤，增强抗氧化系统，减少炎症过程和纤维化；最有可能是通过激活 KEAP1/Nrf2/ARE 通路并停用 NFB 通路。全天然产品含有平衡的抗氧化剂，可以协同作用以产生有益的治疗结果。在这种情况下，更多涉及整个植物或草药产品或不同草药和植物及其活性成分的混合物的临床研究可能会改变我们治疗糖尿病肾病的策略。由于该领域需要预防性干预和研究，天然产品可能有用。