Abstract
In this self-controlled case series, we aimed to investigate the variation in estimated glomerular filtration rate (eGFR) after taking astragalus-containing preparations in patients with mild to moderate chronic kidney disease (CKD) by retrospectively reviewing their charts in our clinic. We set the inclusion criteria as first-visit patients aged 20 years or older presenting to our clinic between 1 October 2014, and 31 June 2019, and who were prescribed astragalus-containing herbal preparations for any reason. We calculated the mean eGFR from the readings taken 6 months before (pre) and after (post) the intake of astragalus-containing preparations for each participant. Among the 37 patients included in our final analysis, we found a statistically significant improvement in the eGFR after prescribing astragalus-containing preparations (pre, 66 ± 12 ml/min/1.73 m2 vs. post, 70 ± 14 ml/min/1.73 m2; p < 0.001 by paired t-test). Our results were consistent regardless of age, sex, CKD stage of the participants (G2 or G3), daily dosage of astragalus root, or duration of astragalus-containing preparations. No severe adverse reactions were recorded in the charts of the study participants. Our results suggest that there is eGFR improvement after taking astragalus-containing preparations in mild to moderate CKD cases as reported previously. The findings should be considered with caution due to major limitations such as small sample size without optimum control, short follow-up period, and incomplete data. Further adequately powered and designed studies are needed to confirm the efficacy and safety of the long-term use of astragalus root in patients with mild to moderate CKD.
Highlights
Chronic kidney disease (CKD) is a long-term and globally widespread health condition
A previous metaanalysis of randomized control trials (RCTs) reported the efficacy of astragalus root on CKD based on estimated glomerular filtration rate; serum creatinine, hemoglobin, and albumin levels; and proteinuria and albuminuria (Li et al, 2011; Zhang et al, 2014; Zhang et al, 2019)
We aimed to investigate the variation in estimated glomerular filtration rate after taking astragalus-containing preparations in patients with mild to moderate CKD by retrospectively reviewing their charts in our clinic
Summary
Chronic kidney disease (CKD) is a long-term and globally widespread health condition. This condition causes a huge economic burden due to end-stage renal disease requiring dialysis (Wang et al, 2016; Neuen et al, 2017; Luyckx et al, 2018). Causes of CKD include high blood pressure, diabetes, glomerulonephritis, polycystic kidney disease, and long-term use of certain medications, such as non-steroidal anti-inflammatory drugs (Kazancioğlu, 2013). Chinese researchers have confirmed that astragalus injection is effective for hypertensive renal damage (Sun et al, 2012). These RCTs and observational studies mainly included patients with severe to end-stage CKD in stages G4 to G5 to avoid disease progression (Okuda et al, 2012). Studies on the efficacy of astragalus root as an early intervention for patients with mild to moderate CKD in stages G2 to G3 are lacking
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