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Kidney diseases are common health problems worldwide. Various etiologies ultimately lead to the development of chronic kidney disease and end-stage renal disease. Natural compounds from herbs or medicinal plants are widely used for therapy and prevention of various ailments, among which is Inonotus obliquus. I. obliquus is rich in triterpenoids and the main active ingredients include betulinic acid, trametenolic acid, inotodiol, and ergosterol. New evidence suggests that I. obliquus triterpenes may be an effective drug for the treatment and protection of various kidney diseases. The aim of this review is to highlight the pharmacological activities and potential role of I. obliquus triterpenes in the kidney disease treatment and protection.