Research Progress on the Regulation of Ferroptosis by Active Components of Traditional Chinese Medicine in the Treatment of Renal Interstitial Fibrosis in Chronic Kidney Disease

Background: Renal interstitial fibrosis (RIF) is a common pathological change in chronic kidney disease (CKD). Many CKD patients exhibit varying degrees of disruption in iron and lipid metabolism. Ferroptosis, a unique form of cell death, has been observed in numerous kidney diseases. Regulating ferroptosis presents a promising therapeutic strategy for RIF. Traditional Chinese medicine (TCM) has shown potential in treating RIF, attracting growing research interest in clarifying its mechanisms. Objectives: This article aims to summarize the role of ferroptosis in RIF and explore the relationship between ferroptosis and TCM monomers, with the goal of identifying new candidate drugs for treating RIF by targeting ferroptosis. Methodology: Through inductive analysis of existing studies, the effects of active components in TCM—such as flavonoids, terpenes, and phenolic acids—on key proteins and signaling pathways were examined. These proteins include GPX4, TFR1, EMT, α-SMA, KEAP1, SLC7A11, Smad3, ATF3, Nrf2, TGF-β1, Smad-2, and FTH. Signaling pathways such as Nrf2/GPX4, TLR/ Nox4, and Nrf2/HO-1 were analyzed to elucidate the regulatory mechanisms. Results: TCM active components were found to modulate the expression of multiple proteins involved in ferroptosis and fibrosis through key signaling pathways. This regulation alleviates oxidative stress and apoptosis, reduces iron deposition, and ultimately inhibits the development of RIF. Conclusion: This review highlights the significance of ferroptosis in RIF and illustrates how TCM monomers can interfere with this process. The findings provide innovative ideas and a theoretical basis for the treatment of RIF by targeting ferroptosis, offering promising directions for future drug development.