Abstract
Objective Current study aimed to investigate the benefits of adjuvant therapy with traditional Chinese medicine on the pediatric primary nephrotic syndrome. Methods A total of 455 patients with PNS admitted to our hospital from January 2010 to January 2019 were divided into the traditional Chinese medicine group (n = 217) and the control group (n = 238). The control group received conventional Western medical treatment, and the traditional Chinese medicine group was treated with traditional Chinese medicine supplemented with Western medical treatment. The differences in remission rate, recurrence rate, and recurrence-free survival between the two groups were evaluated. Results The differences in clinical parameters between the two groups were not statistically significant. Compared with the control group, adjuvant treatment with traditional Chinese medicine increased the clinical remission rate (p=0.037), decreased the relapse rate (p=0.015), prolonged relapse-free survival (p ≤ 0.01), and was an independent protective factor for relapse-free survival in children with PNS (HR = 0.55, 95% CI 0.49–0.63, p ≤ 0.01). In a subgroup analysis of the traditional Chinese medicine formulations, Yuebi Jiazhu Tang, Ganlu Xiaodu Dan, and Yupingfeng granules significantly reduced the risk of recurrence in children (p ≤ 0.01, p ≤ 0.01, p=0.003). Conclusion Adjuvant treatment of pediatric primary nephrotic syndrome with traditional Chinese medicine could benefit the children.
Highlights
Pediatric nephrotic syndrome can be divided into primary nephrotic syndrome and secondary nephrotic syndrome according to the cause, among which primary nephrotic syndrome (PNS) accounts for more than 90% of nephrotic syndromes [1]
A total of 455 children were included in the study, including 238 in the control group, 183 males and 55 females, with a mean age of (4.93 ± 2.25) years, and 217 in the traditional Chinese medicine (TCM) group, 164 males and 53 females, with a mean age of (5.05 ± 2.34) years
In addition to receiving conventional treatment of Western medicine, the children in the TCM group had to have medical records of using TCM. e common prescriptions used in the treatment of pediatric PNS according to the TCM evidence are Yuebi Jiazhu Tang, Ganlu Xiaodu Dan
Summary
Pediatric nephrotic syndrome can be divided into primary nephrotic syndrome and secondary nephrotic syndrome according to the cause, among which primary nephrotic syndrome (PNS) accounts for more than 90% of nephrotic syndromes [1]. Glucocorticoids are the drugs of choice for the treatment of primary nephrotic syndrome in pediatric patients, and they are administered for a longer period time to correct the inflammatory and immune response of the body and affect the permeability of the glomerular basement membrane, exerting a diuretic effect and eliminating proteinuria. Children can be classified into hormone-sensitive and hormone-resistant nephrotic syndrome according to their response to hormone therapy [3]. In China, even if children are sensitive to initial hormone therapy, 80–90% of them still relapse, of which 25–43% are frequent relapses or hormone-dependent [4]. Hormone-resistant, hormone-dependent, and frequently relapsing nephropathies require treatment with hormones in combination with immunosuppressive drugs (e.g., cyclosporine A, tacrolimus, cyclophosphamide, tacrolimus, Journal of Healthcare Engineering and rituximab) [5,6,7]. Long-term use of glucocorticoids leads to an increased risk of adverse effects (e.g., osteoporosis, growth disorders, infections, and obesity) [8], and side effects such as nephrotoxicity, hypertension, and diabetes may occur with calcineurin inhibitors [9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
