Herbal Medicine and Kidney Disease in Ghana: What the Evidence Really Says

According to news reports of a 1 November 2026 appearance on GHOne TV’s Toast programme, family medicine specialist Dr Sompa Otabil-Nelson alleged that more than 40% of people on dialysis in Ghana had kidney disease because of herbal medicine. She raised legitimate questions about dosing, product monitoring and sweeping treatment claims (MyNewsGh, 2026).

A recent television discussion about herbal medicines and kidney failure has revived a familiar argument in Ghana: are herbal preparations damaging people’s kidneys, or are they being blamed without adequate scientific proof? The question matters because kidney disease can kill, but misleading statistics can also harm the public and unfairly distort healthcare policy. We must neither deny genuine dangers nor claim that every illness occurring after herbal use was caused by herbs.

According to news reports of a 1 November 2026 appearance on GHOne TV’s Toast programme, family medicine specialist Dr Sompa Otabil-Nelson alleged that more than 40% of people on dialysis in Ghana had kidney disease because of herbal medicine. She raised legitimate questions about dosing, product monitoring and sweeping treatment claims (MyNewsGh, 2026). The concern deserves serious attention. The specific national percentage, however, requires a scientific basis that distinguishes what patients took from what actually caused their disease.

First, what does it mean when a hospital says 45% used herbal medicine?

Imagine a hospital treats 100 people who already have kidney damage. It discovers that 45 took a herbal preparation. It would be correct to say that 45% of those kidney patients reported herbal use. It would be incorrect to announce that herbs caused kidney damage in 45% of all herbal users—or even that herbs caused all 45 hospital cases. Some patients may have had longstanding hypertension, diabetes, infections or pre-existing kidney disease. Some might have taken herbs because they were already unwell.

To measure risk among herbal users, we need the missing number: how many people took the same product in total, including people who did not become ill? Researchers call that the denominator. For illustration, if 100,000 people used a product and 45 subsequently developed kidney problems, 45 divided by 100,000 is 0.045%, not 45%. Even this calculation alone would not tell us whether the product caused those 45 cases; we would need comparison groups, medical histories and testing. This example is hypothetical, not a Ghanaian prevalence estimate.

The Cameroon study: a genuine warning, not a population risk estimate

Fouda and colleagues (2021) studied 53 patients with acute kidney injury at two Cameroonian general hospitals. Twenty-four—approximately 45%—developed kidney injury within 72 hours after taking traditional preparations. Among these 24 patients, 71% had acute tubular necrosis, a serious injury affecting the small kidney structures that help filter waste. The cases linked by timing to traditional medicines were often severe, and the preparations were generally homemade plant decoctions.

For ordinary readers, the message is twofold. First, suspected injury after herbal use is real and must be investigated; the close timing is an important safety signal. Second, the investigators started with people already suffering kidney injury, not with everyone who had taken a herbal preparation in Cameroon. The study cannot tell us the percentage of all herbal users who will develop kidney damage, nor can timing alone prove the cause in every case.

The Ethiopian children’s study: understanding “2.45 times the hazard”

In Ethiopia, Teshager and colleagues (2024) followed 310 critically ill children admitted to a paediatric intensive care unit. They reported an adjusted hazard ratio of 2.45 for multiple organ dysfunction among children exposed to traditional herbal medicines (95% confidence interval: 1.29–4.65). Multiple organ dysfunction means that at least two vital organs are not working properly.

In everyday language, the measured rate at which this complication occurred was about 2.45 times as high in the exposed group after adjustment for factors included in the statistical model. That is a serious warning that should influence clinical vigilance and further research. It is not the same as saying that 245 children in every 100 herbal users will become ill, and it does not, on its own, prove the herbs caused the organ problems. These children were already critically ill. Of note, the paper was published in 2024, although the manuscript was received in 2023.

The Nigerian liver study: exposure is not the same as causation

Nwokediuko and colleagues (2013) reviewed patients admitted to a Nigerian teaching hospital with liver disease. Among these already-ill patients, 45.5% had consumed herbs or roots, 52.1% reported alcohol consumption and 49.4% had hepatitis B infection. These percentages overlap because an individual may have more than one exposure or condition.

Suppose a patient with hepatitis B also drinks alcohol and uses a herbal preparation. Which factor damaged the liver? A responsible clinician would investigate all three rather than choose the herbal preparation simply because it was mentioned. The Nigerian study measured how common these exposures were among patients with liver disease; it did not prove that herbal products caused 45.5% of Nigerian liver disease. Saying otherwise confuses association with causation.

What research has actually been done in Ghana?

There are relevant Ghanaian studies, and they deserve to be read rather than ignored. Tannor and colleagues (2019) examined 2,781 adults with hypertension, diabetes or both across five healthcare facilities. Herbal medicine use was associated with higher adjusted odds of chronic kidney disease (adjusted odds ratio 1.39; 95% confidence interval 1.10–1.75). This is roughly 39% higher odds, not evidence that 39% of kidney diseases were caused by herbs. Because the study was cross-sectional, it could not establish the direction of causation or identify the particular products responsible.

At Komfo Anokye Teaching Hospital, Okyere and colleagues (2020) reviewed 1,426 patients with kidney diseases over 2005–2017. Hypertension was listed as the leading cause of renal disease presentations (53.93%), followed by chronic glomerulonephritis (19.7%) and diabetic nephropathy (11.09%). This was a hospital-based review, not a national census, but it confirms why discussions of kidney disease must include established causes beyond herbal exposure.

In another Ghanaian study, Acquah-Mills and colleagues (2025) examined 246 people receiving haemodialysis at Cape Coast Teaching Hospital. They found that 54.5% had used traditional, complementary or alternative medicine (TCAM), especially herbal treatments, during their treatment course. The study also reported an association between TCAM use and deaths among the patients. That association deserves attention, especially because people with advanced kidney disease can be unusually vulnerable to toxic substances and interactions.

Yet the Cape Coast study did not establish that TCAM use caused 54.5% of those patients to develop kidney failure, nor that it caused the deaths. Indeed, its study population already had end-stage kidney disease. Traditional and complementary medicine is also a broader category than a single herbal product. Whether someone started treatment before or after diagnosis, which preparation was used and what underlying conditions they had are all essential questions.

Why Ghana needs stronger safety reporting

There is another problem: silence in adverse-event databases is not proof that products are safe. A global analysis of suspected herbal-related liver and biliary adverse reactions recorded only two reports each from Ghana, Nigeria, Kenya and South Africa, and one from Uganda (van Hunsel et al., 2019). Those were liver-related reports, not a national count of kidney injury. The very small figures more plausibly draw attention to limitations of reporting and surveillance than to an absence of harm.

Ghana already has a formal Food and Drugs Authority system for registering herbal medicines and regulating manufacturing and advertising. Nevertheless, registered products, informal home mixtures, adulterated preparations and unidentified substances must not be lumped together as though they were all scientifically interchangeable. Product quality, ingredients, dose, interactions and patient-specific risks matter (FDA Ghana, 2013; FDA Ghana, n.d.).

Research is not just about professional prestige

For African traditional medicine, the case for research goes well beyond gaining academic respect. Clinical evidence will affect the profession’s scope of practice, rights of referral, qualifications, product claims, economic future and role in national healthcare. When regulators ask which diagnoses, treatments and procedures a profession should undertake, experience and assertion alone are not enough. A profession with sound data can make a meaningful submission; one without data may find its future defined chiefly by others.

African institutions already conduct important research on medicinal plants and indigenous practices. The urgent challenge is to connect this work to clinical outcomes, laboratory verification, national adverse-event reporting, practitioner education and collaborative research across the continent. Protecting the profession means being able both to identify genuine hazards and to rebut unsupported attributions with evidence.

A practical way forward

Ghana should establish coordinated studies with nephrologists, pharmacologists, clinical researchers, the Centre for Plant Medicine Research, the FDA, universities and properly qualified traditional and naturopathic practitioners. Research should record the exact product or plant, batch, ingredients, dose, timing, co-medications, pre-existing illnesses and laboratory results. Where possible, investigators should compare exposed and unexposed patients and test retained samples for contaminants, undeclared pharmaceuticals and known nephrotoxins.

Practitioners must report suspected adverse reactions, avoid unsupported cure-all advertising, use appropriate referral thresholds and encourage patients with diabetes, hypertension or kidney disease to obtain clinical monitoring. Patients should tell doctors and herbal practitioners about every medicine or preparation they take and should not abandon prescribed kidney or blood-pressure treatment for unproven remedies. Sudden reduced urination, swelling, severe vomiting or unusual weakness after a preparation requires prompt medical assessment.

Conclusion: let evidence settle the argument

The GHOne controversy provides Ghana with an opportunity to improve public education and research rather than deepen divisions between professions. Some herbal preparations can damage the kidneys; a responsible naturopathic profession must say so plainly. Equally, a percentage of sick patients who used herbs is not, without more rigorous evidence, the percentage whose disease was caused by herbs. No nationally representative study identified for this article establishes the reported claim that herbal medicine caused more than 40% of dialysis cases in Ghana.

Our public-health obligation is to investigate genuine harm, resist false reassurance, avoid unsupported blame and protect patients through sound research. For African naturopathy, evidence is neither decoration nor mere academic respectability: it is the basis of patient safety, credible regulation and professional survival.

About the author

The author is a Ghanaian naturopath, researcher, academic and lawyer admitted to the Bars of Ghana and The Gambia. He is President of Nyarkotey College of Holistic Medicine and Founding President of the African Naturopathic Federation.