Analysis of 111 cases of aristolochic acids nephropathy / 药学实践杂志

Objective To analyze the clinical characteristics and regularity of aristolochic acid nephropathy (AAN) induced by drugs containing aristolochic acid. Methods The clinical data of 111 patients with AAN induced by aristolochic acid were reviewed. The clinical features, medication and treatment of AAN were analyzed. Results Among 111 patients, there were more females than males (2.58∶1), 101 cases (90.99%) were over 50 years old； the mean age was (63.70±11.67) years old;the average duration of medication was (8.08±6.94) years. The drugs involved were Guanxinsuhe pill and Longdanxiegan pill in 106 cases (95.50%). Serum creatinine increased in 108 cases, urea nitrogen increased in 106 cases and hemoglobin decreased in 103 cases, most of which were hypogravity urine, mild to moderate proteinuria and occult blood. Ultrasonic examination revealed that the kidneys were damaged to varying degrees. Pathological biopsy of kidney showed renal tubular damage. Most patients had an insidious onset and varying degrees of progression, which were not proportional to the age and the duration of taking the medicine. In clinical, the renal function was progressively damaged, most of which were irreversible and with a poor prognosis. Conclusion Patients with renal impairment differed greatly individually, and the renal damage was not paralleled with the medication duration and dose of drugs containing aristolochic acid.AAN progressed rapidly, and the disease still progressed even after stopping taking drugs containing aristolochic acid. Strengthening pharmacovigilance, implementing early diagnosis and effective intervention could help to reduce the occurrence of AAN and attenuate its development.

Study on differential expression of miRNA in serum of rats after renal injury induced by aristolochic acid I / 中草药

Objective: To screen the miRNA differential expression profile in serum of rats after renal injury induced by aristolochic acid I, (AAI) to identify the target of miRNA in the mechanism of aristolochic acid nephropathy (AAN), and to make further study on the mechanism of AAN. Methods: Eighteen male SD rats were randomly divided into two groups, control group and AAI group (2.25 mg/kg). Rats were ip injected with AAI once daily for 14 d. On day 14, blood collected was used for the determination of miRNA in serum by miRNA microarray; Renal pathological changes were examined by HE staining. The miRNA that expressed significantly different would be verified by real time quantitative PCR (qPT-PCR). Target genes were predicted using bioinformatics as well as Pathway analysis did. Results: HE staining revealed that kidneys were damaged with different degrees. By significance analysis of microarray based on microarray screening, significantly different expression of five miRNA (miR-10a-3p, miR-207, miR-3594-3p, miR-874-3p, and miR-9a-3p) which were up-regulated were obtained, while there were no miRNAs which were down-regulated. qPT-PCR approved the results as well. It was suggested that 16 genes, such as Rhebl1 and Usp10, might be the target genes. Pathway analysis showed a greater correlation between MAPK signaling pathways. Conclusion: The differential expressed miRNAs obtained by gene analysis might be related with AAI and further studies on the mechanism of some miRNA would be a new target of gene therapy and provide an effective basis for the further studies of bioinformatics.

Pro. Wang Yongjun’s Clinical Experience in Diagnosing and Treating Drug-induced Renal Injury / 浙江中医药大学学报

[Objective] This article is to further sort and excavate the clinical experience of Professor Wang Yongjun on drug-induced renal injury. [Methods] Professor Wang’s experience of prevention and control, and the principle of medication for drug-induced renal injury were summarized, in the light of examples of diagnosis and treatment of gentamicin nephropathy and aristolochic acid nephropathy(AAN).[Results] Drug-induced renal injury has certain clinical characteristics. In addition to the timely drug withdrawal, Professor Wang mainly uses Astragalus membranaceus ligustrazine for gentamicin nephropathy, and treats the AAN with traditional Chinese medicine of tonifying qi, yin and kidney, invigorating the blood, obtaining effectiveness. [Conclusions]Prevention is vital in drug-induced renal injury, and fol owing the safe, effective and control able principles of medication is the primary method to prevent drug-induced renal injury.

Clinical Research of Aristolochid Acid Nephropathy Treated with Jiaweifuzilizhongtang / 中国中医药信息杂志

Objective To investigate the effects on the renal function and the clinical symptoms of patients with aristolochic acid nephropathy (AAN) treated with the Chinese herbal medicine, Jiaweifuzilizhongtang. Method Twenty-seven patients with AAN were treated with Jiaweifuzilizhongtang. The indexes, such as blood urea nitrogen (BUN), serum creatinine (SCr), endogenous creatinine clearance rate (CCr), twenty-four-hour proteinuria quantitate (24 h Upo), ?-N-acetyglocosamidase (NAG), Urine Osmol (Uosm), erythrocyte (RBC), hemoglobin (HB) and so on, were observed before and after treatment, and the score of patients’ symptoms including aversion to cold and cold limbs, lassitude and weakness, poor appetite and anorexia, nausea and vomiting, pale complexion, was also calculated. Result Compared with that of treatment bebore, the renal function of patients after treatment was significantly improved (P

An analysis of the clinical and pathological characteristics of Guan Xin Su He Wan associated tubulointerstitial nephropathy / 中国实用内科杂志

ObjectiveTo study the clinical and pathological characteristics of tubulointerstitial nephropathy associated with Chinese herb patent Guan Xin Su He Wan(GXSHW-TIN).Methods15 patients with GXSHW-TIN were studied.Clinical and pathological data were semi-quantitatively assessed.Relationships between medication and the incidence,clinical characteristics and the outcome of the disease were analyzed.ResultsAll the patients had chronic renal failure when GXSHW-TIN was diagnosed.They all got the disease after long-term taking of GXSHW in routine dosage.Most of the patients presented gastrointestinal dysfunction,abnormal urine analysis and mild to moderate anemia as onset symptoms.The pathological characteristics were similar to those of Guanmutong(Aristolochia manshuriensis Kom) induced chronic aristolochic acid nephropathy(AAN).ConclusionLong-term taking of GXSHW,which contains Radix Aristolochiae,might induce AAN.It indicates that GXSHW should be causious for clinical use,the ban of Radix Aristolochiae in the pharmaceutical market needs to be considered for prevention of AAN.

Treatment for aristolochic acid nephropathy with integrated liposomal prostaglandin E_1 and calcium dobesilate / 中国实用内科杂志

Objective To study the effects of integrated liposomal prostaglandin E_1(PGE_1)and calcium dobesilate on aristolochic acid nephropathy(AAN).Methods Forty-six patients of AAN who came from the First Affiliated Hospital,China Medical University from 2003 to 2005 were randomly divided into control group(PGE_1)and treatment group(PGE_1+calcium dobesilate).Scr and Hb were compared between two groups before and after the treatment.Results Scr had been decreased significantly and Hb had been increased in both groups,but more significantly in treatment group than in control group.Conclusion Integrated liposomal prostaglandin E_1 and calcium dobesilate can ameliorate renal function in AAN.

Changing the Name of Chinese Herbs Nephropathy to Aristolochia Nephropathy or Aristolochic-Acid Nephropathy / 日本東洋医学雑誌

In this article, the proposal to rename “Chinese herbs nephropathy” was reviewed. Prolonged use of Chinese herbs that contain aristolochic acid may induce tubulo-interstitial disorders. In our opinion, the “Chinese herbs nephropathy” nomenclature is equivocal, and should be changed to “aristolochic-acid nephropathy”. Professor Vanherweghem, who is the first author to write about this disease, also used the name “Aristolochia nephropathy.”