In this study, we obtained literature data from the Web of Science (WOS). To ensure that the data we received was both adequate and comprehensive, we utilized two essential components of the Web of Science Core Collection (WoSCC): the Science Citation Index Expanded (SCIE) and the Social Science Citation Index (SSCI). WOS is the most renowned and dependable citation index due to its stringent criteria for the evaluation and selection of journals, and its ability to provide valid and reliable information (23). The period of the study was from January 1, 2000 to January 20, 2024, which ensured comprehensive coverage of the literature we searched. During the literature search, we specified the type of literature to include only ARTICLE and REVIEW, while excluding other types of articles such as editorials, conference proceedings, and letters. At the same time, we set the language to English to minimize the potential comprehension bias arising from language differences. This was done to ensure the consistency and reliability of the data for our analysis. Additionally, we further filtered the literature based on specific keywords and topics related to TCM for CKD to ensure the relevance of the included articles. Finally, we used (TS = CKD OR chronic kidney disease OR chronic renal disease OR chronic renal insufficiency OR chronic kidney insufficiency) AND (TS = patent herbal drug OR herbal medication OR Chinese patent medicine OR herbal medicine OR Chinese herbal preparation OR Chinese herbal medicine OR herbal formulas OR herbal extract OR Chinese herbal decoction OR herbal supplement OR Chinese medicine OR herbal products OR traditional Chinese medicine OR traditional medicine) AND (TS = patent herbal drug OR herbal medication OR Chinese patent medicine OR herbal medicine OR Chinese herbal preparation OR Chinese herbal medicine OR herbal medicine OR traditional herbal medicine OR traditional medicine) as the final search strategy. All search results were exported from WOS and temporarily saved in plain text files for subsequent data processing and further analysis.

In the course of the study, we retrieved and downloaded the data retrieved from WOS on January 25, 2024 to avoid possible errors associated with frequent database updates, and we successfully downloaded a total of 1,153 documents that met the screening criteria of the study. In order to better understand the characteristics and trends of the literature, we adopted R software version 4.2.1 and used “bibliometrixpackage4.0.1” as a tool for bibliometric analysis and data collection. The choice of this tool was based on its wide application and efficiency in the field of literature research. During the data importation process, great attention was paid to the accuracy and completeness of the data. Therefore, after importing the downloaded literature data into the R software, we performed a systematic integrity check and cleaning to ensure the quality of the analyzed data. Subsequently, we imported the critical information of each literature into Microsoft Office Excel (2019 version) in an orderly manner and stored it properly.

We employed the Bibliometrix R software package, CiteSpace, and VOSviewer for different aspects of bibliometric analysis. Each aspect makes a unique contribution to answering research questions. Bibliometrix provides quantitative insights into publication trends, citation analysis, and key author/institution indicators (24), which helps to identify influential research and key players in the field of TCM and CKD. CiteSpace is used to detect research frontiers and knowledge gaps by mapping citation bursts, co-citation analysis, and keyword clustering (25), thereby helping us identify emerging topics and research hotspots. VOSviewer is used for network visualization, including co-authorship networks and national cooperation (26), which illustrates the degree of international cooperation and the structure of scientific influence in this field. This study adopted a combined approach of scientometric analysis and systematic review, similar to the methodology employed by Gholampour et al. (27, 28).

Regarding parameter selection, we chose default settings in some cases, but in other cases, we applied custom parameters to improve the specificity of the analysis. For example, in Bibliometrix, we used a threshold of at least five citations per article to focus on influential works. In CiteSpace, we adjusted the time slice to a two-year interval (2000–2024) to capture the temporal evolution of research trends. For VOSviewer, we selected a minimum co-occurrence threshold of 10 for keywords to ensure that only important trends and connections are visualized. These adjustments were made to optimize the relevance and clarity of the analysis and ensure that the output is directly aligned with our research goals.

The search yielded a total of 1,200 articles pertaining to the correlation between TCM and CKD in the WOSCC database, spanning from January 1, 2000, to January 20, 2024. After excluding 37 studies categorized as book chapter corrections, editing, or materials, as well as six non-English studies, no duplicate studies were identified, resulting in a final count of 1,153 relevant studies. The details of the literature search process can be found in Figure 1.

Through the search strategy mentioned in the Methods section, we retrieved a total of 1,153 eligible articles (Figure 2A). These articles span from 2000 to 2024, and the number of publications increases year by year, showing three main phases: the first phase is from 2000 to 2005, in which the number of published articles is low and offers a slow growth trend; the second phase is from 2006 to 2017, in which the number of documents starts to increase, and the increase becomes more extensive than before, with the number per year up to more than 50 articles; the third phase is from 2019 to 2024, the number of articles published within these years increased dramatically, indicating that the study became a research hotspot in recent years, and the year with the highest number of published literature is 2022, with the number of all 174 articles, and the citation frequency is at the highest end of the scale, with the total number of citations in the literature being 3,508, which indicates that more high-quality studies were published in this year. The highest average number of literature citations was in 2012, which equates to an average of 25 citations per document in that year. The country with the highest percentage of publications is China, followed by the United States; the distribution of the top 10 countries with the highest number of publications in terms of the year of publication is shown in (Figure 2B), where China has been involved in the publication of articles in the related field from 2000 to 2024, with a very high level of contribution to the field; followed by the United States, where the number of publications has gradually increased in the field from 2008 onwards. According to R software statistics, these 1,630 articles came from 5,358 co-authors from 77 countries, were published in 426 journals, and cited a total of 54,064 references (Figure 2C). The country with the highest percentage of publications is China, followed by the United States. This dominance reflects China’s long-term investment and policy support for TCM research, especially with a focus on chronic diseases like CKD. The United States, despite publishing fewer papers, shows a higher citation per article, which can be attributed to its extensive international collaborations and its leadership in global research funding. Additionally, countries like India, Iran, South Korea, and Japan have been able to establish themselves as scientific leaders in this field due to the increasing governmental support, academic infrastructure, and a growing focus on complementary and alternative medicine.

Among the 1,153 papers included in the study, we conducted a visual network analysis of the countries involved in the issuance of the documents, and the number of statistical countries was not limited to the first and corresponding authors. Still, it was distributed in 77 countries, mainly in China, Europe, and the United States (Figure 3A). China has the highest number of literature with 760, followed by the United States with 132 and India with 44, while the rest of the countries do not have more than 50 literature (Table 1). The countries with the highest number of citations in literature were China with 12,885 citations in published literature, the United States with 6,107 citations in published literature and India with 697 citations in published literature. (Figure 3B) shows the visualized international collaboration network, with the size of the circle and chord plot area representing the number of citations. It can be seen that most of the collaborations are related to China and the United States, mostly centered on developed countries, while collaborations among other countries are relatively weak. Most countries have multinational collaborative research, with the United Kingdom having the highest percentage of international collaborative articles, and IRAN, Japan and Korea having fewer international collaborative articles (Figure 3C). This outcome might reflect China’s long-term scientific research investment and policy support in the field of traditional Chinese medicine, particularly the encouragement of research on traditional Chinese medicine at the national level. On the other hand, the high citation frequency in the United States might be related to its significance in the global scientific research system and the extensiveness of its scientific collaborations.

We performed network visualization and density visualization analysis of issuing organizations by VOSViewer software. (Figures 4A,B) The connecting line represents the cooperation relationship between organizations, the size of the circle represents the number of times of issuance, and the node color changes from purple to yellow to represent the passage of time. We set the minimum number of collaborations as 5 times and constructed 102 inter-organizational collaborations. Among them, there were more collaborations with Nanjing University of TCM, Shanghai University of TCM and Guangzhou University of TCM, and most of them were TCM-related medical universities. At the same time, the other organizations maintained a stable pattern of group collaborative research, and there were fewer collaborations between multinational organizations. The average year of literature published by these organizations is more centered, and most of them have published papers in the last 10 years. (Figure 4C) shows the trend of publications for some organizations; institutions are not limited to those to which the first and corresponding authors belong. The largest number of publications was from the Guangzhou University of Traditional Chinese Medicine (60); followed by the Shanghai University of Traditional Chinese Medicine (54) and Nanjing University of Chinese Medicine (49) (Table 2). It can be seen that Guangzhou University and Shanghai University of Traditional Chinese Medicine have a large influence in this field, and the number of articles published in recent years is also very high. In conclusion, the analysis indicates that there is a relatively concentrated collaboration pattern among TCM-related medical universities in China, and these universities have made substantial contributions to the research in this field in recent years. However, there is still room for further enhancing international collaboration to promote the development of TCM research on a global scale.

Among the articles included in this study, we drew a visual map of the participating journals (Figure 5A), where the size of the circle represents the number of published articles, from which it can be seen that Frontiers in Pharmacology, Journal of Ethnopharmacology, and Evidence-Based COMPLEMENTARY are the journals with high impact in this study area. All three journals are pharmacy related journals. Meanwhile, we presented the journals involved in the study in the form of a publication time distribution graph (Figure 5B), in which the color of the nodes changes from purple to yellow, representing the progression of time, which shows that “journal of ethnopharmacology,” as an influential journal in the field, has a long average publication time. In contrast, “Frontiers in Pharmacology have been involved in publishing more articles in recent years (Table 3). In addition, we analyzed the association between citing journals and cited journals using a journal double-stacked graph (Figure 5C). The diagram’s left side represents the citing journal, the right side denotes the cited journal, and the color-coded lines illustrate the connection between the citing and cited journals. The figure mainly shows that articles in molecular, biology, and immunology especially cited articles in molecular, biology and genetics, as well as articles in medicine and clinical medicine mainly cited articles related to life sciences and nursing in this collection. The focal points of these journals, such as pharmacology and ethnopharmacology, are closely related to the theme of this research, and their high influence in the relevant fields makes them the preferred journals for researchers to choose.

Through data calculation, a total of 5,358 authors participated in the submission; Figure 6A lists the co-authorship network of authors who published more than 4 papers, and plots the co-authorship network with 74 authors participating. The connecting line indicates the cooperation between individual authors, the size of the circle shows the number of published papers, and the color of the node changes from purple to yellow to indicate the time progression. It can be seen that the collaboration between authors is mainly in the form of groups, and these authors mostly use institutions as a mode of collaborative research, with relatively little cooperation across institutions. Figure 6B shows the change in authors’ publication time, which shows that several Chinese scholars with high impact published more articles before 2022, and these scholars were involved in publishing articles in all periods. Table 4 presents the 10 authors deemed most pertinent within the realm of Chinese medicine research, all of whom have authored nine or more articles. Collectively, these 10 authors have contributed 131 publications, representing 11.36% of the total literature in this field. Notably, all authors hail from China and have made substantial impacts on the field. Leading the cohort is Liu xinhui, with 17 published papers, followed closely by other esteemed scholars. The distribution of publication years among the top 10 most relevant authors is depicted in Figure 6C. The majority of these authors commenced publishing after 2012, with only a small number having made contributions to the field for over a decade. The co-authorship network in this field shows a certain degree of group collaboration, and Chinese scholars play a leading role. However, there is still room for further strengthening international collaboration and promoting more diverse and extensive research cooperation.

The keywords of an article can represent the topic and main ideas of the article, and by constructing a recurrence map of keywords, the research hotspots and trends in the field can be described. We used VOSviewer to visualize and analyze the keywords that appeared 10 times or more in the articles, and obtained a total of 180 keywords (Figures 7A,B). The larger or darker color of the circle represented by a keyword indicates that the keyword occurs more frequently and defines a research hotspot in the field; moreover, the connecting line between two keywords indicates that they co-occur in the same article, and its thickness is proportional to the frequency of co-occurrence. It can be seen that the most frequently used keywords in this research field are “chronic kidney disease,” “oxidative stress,” “traditional Chinese medicine,” and “inflammation,” and the keywords with more than 20 occurrences are roughly divided into four color groups (Table 5). The keyword “chronic kidney disease” is at the center of all articles. The keyword “chronic kidney disease” was at the center of all the articles. We performed cluster analysis of the keywords by Citespace software, and 11 clusters were calculated, which were #0prevalence, #1renal fibrosis, #2medicinal plants, #3 traditional Chinese medicine, #4gut microbiota, #5chronic renal failure, #6aristolochic acid, #7carotid intima-media thickness, #8alzheimers disease, #9nitric oxide, #10 black cohosh (Figure 7C), where the keyword cluster #0prevalence contains the highest number of keywords and the highest number of associations with other keywords, i.e., the highest number of simultaneous occurrences in a document. In order to visualize the change of keywords over time, we constructed a keyword timeline graph (Figure 8A); the size of the k node represents the frequency of keyword occurrence, the color of the circle depicts the average time of occurrence, and the color changes from purple to red as the chronological order changes from 2000 to 2024. It can be seen in the graph that the distribution of keywords in cluster #0prevalence is more even, and the distribution of keywords in the other the keyword distribution of cluster #0prevalence is more dispersed, and some keywords used before 2005 are still consistently used over a long period. It can be seen that cluster #0prevalence has the richest keyword evolution and the most resounding impact on the clusters. In addition, we calculated the bursting trend of keyword occurrences by Citespace software. Figure 8B shows the 25 keywords with the highest bursting intensity, with the blue line representing the length of occurrences and the red line representing the length of keyword bursts. Among these 25 keywords, the keyword with the highest burst intensity is “network pharmacology,” which mainly appears between 2022 and 2024, and belongs to the explosive research hotspot; the keyword with the most prolonged burst duration is “interstitial renal fibrosis,” which indicates that this research direction is a hot research direction for scholars for a long time. The most prolonged duration of the outbreak is “interstitial renal fibrosis,” indicating that this research direction has been a hot research direction for scholars for an extended period, but the research intensity gradually decreased after 2010. The analysis of keywords and clusters reveals the key research topics and trends in the field of chronic kidney disease and traditional Chinese medicine. The centrality of “chronic kidney disease” and the distribution of other keywords provide an overview of the research landscape. The identification of emerging hotspots like “network pharmacology” and sustained research directions like “interstitial renal fibrosis” is crucial for guiding future research.