CAM may be an important risk for the development of acute and chronic kidney injury for several reasons: non-conventional preparations rarely meet the required essential standards of consistency in composition and biological activity; many of these products contain undisclosed OTC or prescription drugs or can be adulterated with hormones and glandular extracts; herbal preparations can be contaminated by pesticides and heavy metals; and through errors in plant identification and confusing terminology, opportunities for mistakes and deliberate substitution can occur. Furthermore, there is a lack of reports of adverse events and drug interactions because of a lack of professional surveillance, and specific data on systemic and kidney toxicity are not easily available. Kidney injury/kidney syndromes caused by CAM consist of acute tubular necrosis/toxicity (e.g. Fanconi’s syndrome), acute interstitial nephritis, papillary necrosis, hypertension, kidney stones, urinary retention, chronic tubulointerstitial nephritis with fibrosis, urinary tract carcinoma and acute rejection of the kidney transplant. To improve the care for patients using CAM, extension of physicians’ knowledge about its possible hazards and toxicity is essential.