Toxicity
Aristolochic acids are hypothesized to be causative agents in Balkan endemic nephropathy; and a related—possibly identical—condition known as "Chinese herbs nephropathy". Exposure to aristolochic acid is associated with a high incidence of uroepithelial tumorigenesis, and was linked to aristolochic acid-associated urothelial cancer in a 2012 Taiwanese study.
In April 2001, the Food and Drug Administration issued a consumer health alert warning against consuming botanical products, sold as "traditional medicines" or as ingredients in dietary supplements, containing aristolochic acid. The agency warned that consumption of aristolochic acid-containing products was associated with "permanent kidney damage, sometimes resulting in kidney failure that has required kidney dialysis or kidney transplantation. In addition, some patients have developed certain types of cancers, most often occurring in the urinary tract."
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