In Nigeria, when you have malaria, back pain, typhoid, low sperm count, or even a stubborn headache, someone will point you to agbo. The brown, bitter herbal mixture sold in recycled Eva water bottles by the roadside. It’s cheap. It’s “natural.” It’s what our forefathers used.
But in nephrology wards doctors are seeing a different side of agbo. Young men and women in their 30s with kidneys that have aged 50 years overnight. Patients who never had diabetes or hypertension, yet need dialysis 3 times a week to stay alive.
The question nobody asks until it’s too late: What exactly is in your agbo, and what is it doing to your kidneys?
1, It’s a name we give to thousands of unregulated, untested herbal concoctions.
What goes inside?
Depends on the seller, the ailment,
Barks and roots: Dogonyaro, mango bark, cashew bark, moringa root
Leaves: Scent leaf, bitter leaf, guava leaf, pawpaw leaf
Others: Alligator pepper, ginger, garlic, lime, potash, and sometimes ‘secret ingredients’ the seller won’t disclose
The problem: No NAFDAC number. No dosage. No list of ingredients. No clinical trials. One bottle can have 15 plants. Another bottle from the same seller next week can have 8. You’re drinking a chemical lottery every time.
We’re dealing with unknown compounds, in unknown quantities, taken at unknown frequencies, for unknown durations. That’s not medicine. That’s experimentation on yourself.
How Your Kidneys Get Caught in the Crossfire
Your kidneys are your body’s master chemists. They filter 50 gallons of blood daily, removing waste and balancing chemicals. They’re tough, but not invincible.
Three ways agbo destroys them:
A Direct Toxicity
Many plants contain aristolochic acid, pyrrolizidine alkaloids, and oxalates. In small doses, maybe your liver handles them. In high, repeated doses, they scar kidney tissue directly. This is called herbal nephropathy.The damage is often irreversible.
The most notorious is Aristolochia- found in some “anti-infection” agbo. It causes rapid kidney fibrosis. In Belgium in the 1990s, a weight-loss herb with aristolochic acid caused an epidemic of kidney failure. Nigeria is seeing its own version now.
B, Heavy Metals and Contaminants
Where are the plants harvested? Roadsides with lead from exhaust fumes. Dumpsites with mercury and cadmium. Farms sprayed with pesticides. The soil, water, and air contaminants end up in your bottle.
A 2022 study by UNILAG tested 40 agbo samples in Lagos markets. 70% contained lead above WHO limits. 45% had cadmium These metals accumulate in kidneys and never leave.
C, The “Booster”Problem: Mixing With Painkillers
Many Nigerians take agbo _and_ Feldene, Alabukun, or ibuprofen for body pain. NSAIDs reduce blood flow to kidneys. Add a toxic herb on top, and you’ve created an acute kidney injury. We see this every harmattan – patients come in after treating catarrh with agbo + 2 Alabukun sachets daily.
The data available ,1 in 7 Nigerians has some form of chronic kidney disease. That’s over 30 million people
UCH Ibadan Review, 2019- African Journal of Nephrology
Finding: Aristolochic acid nephropathy is rising in Nigeria. The plant Aristolochia ringens is common in “anti-infection” agbo. It causes irreversible kidney scarring within months.
We are seeing a pattern similar to the Belgian slimming herbs epidemic of the 1990s, but with local plants.
“The kidneys don’t know the difference between ‘natural’ and ‘poison’. Aristolochic acid from herbs is natural, and it will destroy your kidneys naturally too. We’re doing post-mortem medicine- patients come when it’s too late.”
Prof Arogundade (OAU) Teaching Hospital, said “A patient spends their life savings in 6 months of dialysis. Then they die. The family is bankrupt and bereaved. All because of a ₦300 herbal mixture they thought was harmless”.
70% of Nigerians with end-stage kidney disease die within 12 months because they can’t afford treatment.
We’re losing breadwinners in their prime to a preventable crisis.
4 Culture: “My grandfather drank agbo and lived to 90.” Survivorship bias. We don’t hear from the grandfathers who died at 45 from kidney failure in 1965
“stop taking agbo” won’t work. We need a prong approach:
Government & NAFDAC:
1,Regulate, don’t just ban: Create a simplified approval path for traditional medicines. Test for toxicity and heavy metals. If it’s safe, certify it. If not, pull it.
3, Subsidize dialysis: we can subsidize survival. NHIS must cover at least 80% of dialysis costs.
1,Ask the question: “Do you take agbo?” should be part of every clinical history. No judgment. Just data.
2,Report cases: We need a national registry of herbal-induced kidney injury to show policymakers the scale.
Check your BP and blood sugar every 6 months if you’re over 30. Early CKD has no symptoms.
4,Drink water: 2-3 liters daily helps kidney flush toxins. Most agbo drinkers are chronically dehydrated.
Our forefathers drank herbs. True. But they weren’t drinking herbs contaminated with lead from car exhaust, mixed with industrial paracetamol, while also taking 4 painkillers daily and eating Maggi-loaded food with zero checkups.
The agbo of 1960 is not the agbo of 2026. The environment changed. The chemicals changed. The risks changed.
Your kidneys don’t care if it’s “natural.” They care if it’s toxic. And right now, too many Nigerians are finding out the hard way that the cure they trusted is the poison that’s killing them.
Avoid alcohol abuse , unsafe water, counterfeit drugs,and poor diets ,as these habits can cause severe kidney damage.
Check your kidneys. Protect your kidneys.
Susan Ajimuda is a Chief Nursing Officer and Nephrology Specialist with the Federal Ministry of Health. A member of both the Nephrology Society of Nigeria and the International Society of Nephrology
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