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Yi-Shen-Hua-Shi (YSHS) is a patented traditional Chinese medicine formulated as granules, consisting of a mixture of 16 herbs. [1, 2] It is developed and manufactured by Guangzhou Consun Pharmaceutical Co. Ltd. [1, 12, 13] YSHS is used clinically for the treatment of various kidney diseases, including chronic kidney disease (CKD), IgA nephropathy (IgAN), diabetic kidney disease (DKD), and chronic glomerulonephritis. [1, 4, 9, 16] Clinical and preclinical studies have shown that it can improve renal function, reduce proteinuria, and alleviate edema. [1, 4] The mechanism of action is complex and multifactorial, involving the modulation of the gut microbiota (the "gut-kidney axis"), regulation of the immune system via the ALG3/PPAR-γ/NF-κB pathway, and inhibition of signaling pathways associated with fibrosis and apoptosis, such as the TGFβ/Smad, PI3K/AKT/mTOR, and GRP78/CHOP pathways. [1, 4, 9]
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