Astragaloside IV is a primary active compound extracted from Astragalus membranaceus, a traditional Chinese medicinal herb. Its use for supporting kidney health has both a traditional foundation and a growing body of modern scientific research, though most evidence comes from preclinical studies.

In traditional Chinese medicine, Astragalus is often used to "tonify Qi" and support kidney function, especially in chronic kidney disease (CKD) contexts. Modern research has begun to investigate Astragaloside IV for these purposes. Several animal studies and some limited human clinical trials have suggested that Astragaloside IV can reduce proteinuria, decrease renal fibrosis, and mitigate oxidative stress and inflammation in kidney tissues. Mechanistically, it appears to exert protective effects by modulating the TGF-β/Smad signaling pathway, reducing pro-inflammatory cytokines, and enhancing antioxidant defenses.

However, robust large-scale clinical trials in humans are still lacking, and most current data come from laboratory or animal models. As such, while scientific interest and preliminary evidence are promising, the strength of the evidence is moderate and not yet definitive. More high-quality human studies are needed to confirm efficacy and safety.