Is Diosmin Safe for Kidneys? A Comprehensive Review

Diosmin is a naturally occurring plant flavonoid, most commonly extracted from citrus fruits, that has gained considerable popularity in recent years for its role in managing chronic venous insufficiency, hemorrhoids, and other vascular disorders. While its benefits for blood vessel health are well-documented, questions remain regarding its safety—particularly for kidney health. With the rising use of over-the-counter supplements containing Diosmin, both consumers and healthcare professionals are increasingly interested in understanding its renal safety profile. This article provides a detailed review of current evidence regarding the effects of Diosmin on kidney health.

Understanding Diosmin and Its Uses

Diosmin works primarily by strengthening vessel walls, reducing inflammation, and improving lymphatic flow. Because of these properties, it is widely used in Europe and parts of Asia to treat leg swelling, varicose veins, and acute and chronic hemorrhoid attacks. Diosmin is often combined with another flavonoid, Hesperidin, and is found in prescription and non-prescription products.

In addition to its primary use in vascular conditions, diosmin is also under investigation for its antioxidant properties and potential protective effects in a variety of inflammatory conditions. However, this widespread use brings about legitimate concerns regarding the impact of diosmin on the kidneys, particularly in individuals with pre-existing renal impairment or those at risk of kidney disease.

Pharmacokinetics and Renal Handling

After oral ingestion, diosmin is absorbed from the intestine and metabolized mainly by gut flora into its active form, diosmetin. Diosmetin is then further processed in the liver and its metabolites are mostly excreted through the kidneys into the urine. Because renal excretion is a main elimination route, there is theoretical concern that diosmin or its metabolites may accumulate or cause adverse effects in individuals with compromised renal function.

Preclinical and Clinical Evidence

1. Animal Studies

Numerous animal studies have been conducted to assess the safety of diosmin, often using doses much higher than those intended for human use. In studies published in peer-reviewed journals such as Food and Chemical Toxicology, rats given diosmin for several weeks to months showed no significant alterations in kidney tissue under the microscope or in laboratory tests evaluating kidney function, such as serum creatinine and blood urea nitrogen. No evidence of irreversible kidney injury or nephrotoxicity has been demonstrated in these controlled animal studies.

2. Human Studies

In humans, clinical trials of diosmin for chronic venous insufficiency, including studies with thousands of participants, have not shown a marked increase in kidney-related adverse events. Most side effects attributed to diosmin are mild and relate to the digestive or nervous systems—such as stomach upset or headache—rather than to renal function.

A large observational study in Europe, tracking over 9,000 adults who took diosmin daily for several months, did not report a significant increase in renal complications compared to the general population. Kidney function markers, including serum creatinine and glomerular filtration rate, were not negatively affected in routine monitoring.

3. Special Populations: Those with Kidney Disease

There are currently few published reports on the use of diosmin in people with chronic kidney disease (CKD) or severe renal impairment. Because diosmin metabolites are cleared by the kidneys, patients with advanced kidney disease could, in theory, experience accumulation of the drug, though clinical support for this concern is lacking. So far, no reports have implicated diosmin in causing or worsening kidney failure in pre-existing CKD patients, but the data remains thin. As a result, it is generally recommended to use caution and seek medical advice before taking diosmin supplements if you have significant renal impairment.

Antioxidant and Anti-Inflammatory Effects: Possible Renal Benefits?

Interestingly, some experimental research hints that the anti-inflammatory and antioxidant properties of diosmin may benefit the kidneys, particularly in models of toxin-induced kidney injury or diabetic nephropathy in laboratory animals. These studies, however, remain preliminary and have not been translated into human recommendations.

Drug Interactions and Precautions

Diosmin is not widely recognized to interact with medications that could harm the kidneys (such as NSAIDs, certain antibiotics, or chemotherapy drugs). However, as with any medication or supplement, caution should be exercised when combining it with other treatments, particularly in individuals with multiple chronic health problems or frail kidney function. Additionally, patients with serious liver conditions should consult their physician before use, as impairments in hepatic metabolism could indirectly affect renal drug clearance.

Regulatory Guidance

Diosmin is approved for use in several countries for vascular health, and no regulatory agency has issued specific renal warnings about its use at recommended doses. In the United States, diosmin is available as a dietary supplement and is thus less strictly regulated for proven efficacy and safety than prescription drugs. Consumers should rely on reputable brands and discuss supplement use with their healthcare providers, especially if they have existing health concerns.

Conclusion: Safety of Diosmin for Kidneys

Based on the available evidence, diosmin appears safe for kidney health in adults with normal renal function when taken at appropriate doses. Major clinical trials and post-marketing surveillance have not shown an increased risk of kidney damage. For those with chronic kidney disease or other significant health issues, the lack of robust data means that caution and medical supervision are warranted.

Ultimately, diosmin remains a valuable treatment option for venous disorders, with a generally favorable safety profile. The key to avoiding complications is awareness, appropriate use, and regular consultation with a healthcare provider, especially if you have pre-existing kidney concerns. With these precautions, diosmin can be used safely alongside other therapeutic strategies without undue risk to renal health.

References:

- Food and Chemical Toxicology. Subchronic Toxicity Study of Diosmin. 2008.  

- European Journal of Vascular and Endovascular Surgery. Diosmin Safety in Clinical Use.  

- British National Formulary (BNF).  

- National Institutes of Health. Dietary Supplements Fact Sheets.