General acteoside of rehmanniae leaves in the treatment of primary chronic glomerulonephritis: A randomized controlled trial

W Fan,P Fu,Hui Zhong,F Chen,H Qiu,C Zuo,P Feng,L Zhou,F Liu,Y Liang,M Shi

doi:10.4314/ajtcam.v10i4.18

Abstract

The objective of the study was to investigate the effectiveness and efficacy of the randomized, parallel, and controlled trial of Traditional Chinese Medicine, general acteoside of Rehmanniae leaves, compared with piperazine ferulate in the treatment of primary chronic glomerulonephritis. Rehmanniae leaves and piperazine ferulate can reduce proteinuria and erythrocyturia effectively in the treatment of primary chronic glomerulonephritis. A total of 400 patients diagnosed with primary chronic glomerulonephritis were recruited from outpatient clinics and were randomly assigned to the treatment group (general acteoside of Rehmanniae leaves, two 200mg tablets, bid) or the control group (piperazine ferulate, four 50-mg tablets, bid ). The primary outcome was 24-h urinary protein. Secondary outcome measures included estimated glomerular filtration rate (eGFR), erythrocyturia, and electrolytes. After 8 weeks of treatment, the treatment group and the control group showed a mean reduction in 24-h proteinuria of 34.81% and 37.66%. The 95% CI of difference of the mean reduction in 24-h proteinuria between the two groups was [-11.50%, 5.80%]. No significant differences were found between the two groups in the erythrocyturia reduction. Neither group showed obvious changes between baseline and 8 weeks in eGFR or electrolytes. Adverse events occurred at a similarly low rate in the treatment group (1.5%) and control group (2.5%, P = 0.7238). Both general acteoside of Rehmanniae leaves and piperazine ferulate can reduce proteinuria and erythrocyturia effectively in the treatment of primary chronic glomerulonephritis.

Highlights

Chronic glomerulonephritis is one of the most common causes of end-stage renal disease among chronic kidney disease patients in China (Zhang et al, 2012)
Studies in animal models of kidney disease have shown that general acteoside Rehmanniae leaf extract is associated with a reduction in urinary protein excretion (Shen et al, 2010b)
Clinical trials have demonstrated the ability of general acteoside from Rehmanniae leaf extracts to improve clinical symptoms of patients with chronic glomerulonephritis (Zhou et al, 2005)

Summary

Introduction

Chronic glomerulonephritis is one of the most common causes of end-stage renal disease among chronic kidney disease patients in China (Zhang et al, 2012). Risk factors associated with poorer outcomes include urinary protein, and impaired renal function (Holtkamp et al, 2011). Proteinuria has proven to be the most important predictor of renal failure, and therapeutic efforts have been focused on its reduction (Wilmer et al, 2003). Traditional Chinese Medicine – general acteoside – refers to several substances present in extracts of. Studies in animal models of kidney disease have shown that general acteoside Rehmanniae leaf extract is associated with a reduction in urinary protein excretion (Shen et al, 2010b). Clinical trials have demonstrated the ability of general acteoside from Rehmanniae leaf extracts to improve clinical symptoms of patients with chronic glomerulonephritis (Zhou et al, 2005)

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Conclusion