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ObjectiveTo observe the clinical efficacy and safety of Chinese herbal enema combined with fumigation as adjunctive therapy for non-dialysis chronic kidney disease （CKD） patients of stage 3-5 with spleen-kidney yang deficiency and turbid toxin blood stasis pattern. MethodsA total of 120 non-dialysis CKD，patients of stage 3-5 with spleen-kidney yang deficiency and turbid toxin blood stasis pattern were randomly divided into treatment group and control group， with 60 cases in each group. The control group received conventional western medical treatment， while the treatment group additionally received Chinese herbal enema combined with fumigation， with enema and fumigation performed alternately， once every other day， three times a week. The treatment course for both groups was 4 weeks. The levels of serum creatinine （Scr）， estimated glomerular filtration rate （eGFR）， and the total score of traditional Chinese medicine symptoms were compared before and after treatment in both groups. The efficacy of traditional Chinese medicine symptoms and clinical efficacy were compared between the two groups after treatment. Adverse reactions in both groups were observed during the treatment period. ResultsThe total score of traditional Chinese medicine symptoms was significantly reduced after treatment in both groups （P＜0.01）. Compared to the control group after treatment， the treatment group showed significant decreases in Scr and the total score of traditional Chinese medicine symptoms， and a significant increase in eGFR （P＜0.05）. The total effective rate of traditional Chinese medicine symptoms in the treatment group （96.67%） was higher than that in the control group （46.67%， P＜0.01）， as well as the total effective rate of clinical efficacy in the treatment group （75.00%） versus that in the control group （28.33%， P＜0.01）. During the treatment period， the vital signs of patients in both groups remained stable， and there were no significant abnormalities in blood routine， urine routine， stool routine， liver function indicators， and electrocardiogram after treatment. ConclusionChinese herbal enema combined with fumigation as adjunctive therapy can significantly alleviate clinical symptoms， improve renal function， and demonstrate good safety for non-dialysis CKD patients of stage 3-5 with spleen-kidney yang deficiency and turbid toxin blood stasis pattern.
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Objective To investigate the clinical effect of LUO's Nephropathy Recipe Ⅲ(composed of Sargassum,Astragali Radix,Salviae Miltiorrhizae Radix et Rhizoma,Rehmanniae Radix Praeparata,calcined Ostreae Concha,Houttuyniae Herba,Schizonepetae Spica,etc.)combined with conventional western medicine in treating stage 3-5 non-dialysis chronic kidney disease(CKD)of spleen-kidney deficiency with turbidity-toxin-stasis obstruction type.Methods A total of 180 patients with stage 3-5 non-dialysis CKD of spleen-kidney deficiency with turbidity-toxin-stasis obstruction type were randomly divided into observation group and control group,with 90 cases in each group.The control group was given conventional western medicine for symptomatic treatment,and the observation group was treated with LUO's Nephropathy RecipeⅢon the basis of treatment for the control group.The course of treatment for the two groups covered one month.Before and after treatment,the levels of serum inflammatory factors,renal function indicators and urine protein parameters in the two groups were observed.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)After one month of treatment,the total effective rate in the observation group was 95.56%(86/90)and that in the control group was 81.11%(73/90).The intergroup comparison(tested by chi-square test)showed that the efficacy of the observation group was significantly superior to that of the control group(P＜0.01).(2)After treatment,the serum levels of inflammatory factors of transforming growth factor β1(TGF-β1),monocyte chemotactic protein 1(MCP-1),and tumor necrosis factor α(TNF-α)in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the levels of renal function indicators of blood urea nitrogen(BUN),serum creatinine(Scr),blood uric acid(UA),and cystatin C(Cys-C)in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.01).(4)After treatment,the levels of 24-hour urine protein quantification and urine microalbumin in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease in the observation group was significantly superior to that in the control group(P＜0.01).(5)The incidence of adverse reactions in the observation group was 4.44%(4/90),which was significantly lower than that of 15.56%(14/90)in the control group,and the difference was statistically significant between the two groups(P＜0.05).Conclusion LUO's Nephropathy Recipe Ⅲ combined with conventional western medicine exerts satisfactory efficacy in treating stage 3-5 non-dialysis CKD patients with spleen-kidney deficiency with turbidity-toxin-stasis obstruction syndrome type,and the therapy can significantly alleviate the inflammatory response,improve the renal function,decrease the urinary protein excretion of the patients,with high safety profile.
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Objective: Hypertension (HTN) is both a cause and an effect of chronic kidney disease (CKD). To adequately control blood pressure (BP) in CKD, choosing antihypertensive strategies with the highest nephro-protective effect is crucial for preventing or reversing end-stage renal disease (ESRD) progression and reducing cardiovascular disease (CVD) risk. The present study was therefore designed to evaluate the impact of clinical use of antihypertensive drug therapy in patients with CKD and ESRD. Methods: It is a prospective observational cohort study. The patients were divided into two cohorts i.e.; non-dialysis dependent (NDD) and dialysis-dependent (DD) CKD. This study was conducted for six months in the Nephrology department, Osmania General Hospital, Hyderabad, India. The data collected and entered into Microsoft Excel (2007) and mean, SD and range were calculated using SPSS version 25. Results: Antihypertensive drugs were prescribed alone or in combination based on the co-morbidities associated with CKD and HTN. Loop diuretics (Furosemide and Torsemide) and calcium channel blocker (Amlodipine, Nifedipine and Cilnidipine) were most commonly prescribed antihypertensive drugs. Triple therapy (44.11%) was prescribed mostly in both the cohorts (NDD = 16.66%+DD = 27.45%) of which calcium channel blockers+loop diuretic+sympatholytic accounts for 19.16% (NDD = 5.88%+DD = 13.73%). Conclusion: The practice of prescribing antihypertensive drugs for the management of HTN and to achieve BP targets in CKD and ESRD remains uncertain. The development of new and revised guidelines is needed to reduce inappropriate variations in practice and promote better delivery of evidence-based treatment.
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Background: A decrease in the glomerular filtration rate (GFR) shows chronic kidney disease (CKD). It may develop any structural or functional renal abnormalities. Methods: 140 total number of cases were included. This study was conducted in the Department of Pathology in Krishna Mohan Medical College & Hospital, Mathura, U.P, India. Result: The mean fasting blood sugar was 133.29 ± 12.63; the mean Post prandial blood sugar was 155.82 ± 12.56. The mean Hb1Ac were 6.16 ± 1.36 and serum creatinine was 3.76 ± 1.36 mg/dl. Finally, the mean hemoglobin for the whole sample was 10.74 ± 2.17 gm%. Conclusion: This study concludes that in future one could carried out research on large sample size along with a matched control group, simultaneous assessment of other biochemical parameters, and burden of various other metabolic for better results.
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[Objective]To discuss the clinical experiences and unique views of professor CHEN Hongyu in treating chronic kidney disease at the fifth stage (non-dialysis).[Method]To analyze the professor CHEN Hongyu's understanding about the pathogenesis of chronic kidney disease and her academic point of view that treating from spleen and kidney. To sum up the clinical experiences in treating CKD5 (non-dialysis) according to invigorating the spleen and kidney, and analyze typical clinical case. [Result] Professor CHEN Hongyu considers that the root cause of CKD is the spleen and kidney deficiency and often accompanied by pathogenic dampness or blood stasis or turbidity toxin. Also rheumatic is an important risk factor for prompting disease activity and protracted course, which is easy to cause kidney deficiency, renal bi and is usually poor for the prognosis. Professor CHEN Hongyu considers protecting spleen and stomach and invigorating the spleen and kidney as the fundamental law, making good use of application of modern technology, emphasizing the combination of macro and micro, treatment based on syndrome differentiation,which has obvious curative effect to remit or eliminate clinical symptoms in patients with chronic renal disease, beneficial to delay the progress of the renal function and improve life quality.[Conclusion] Professor CHEN Hongyu 's experience in treating chronic kidney disease fifth stage(non-dialysis) is worth learning and spreading.
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The aim of this study is to obtain body composition parameters for early detection of PEM in non dialysis CKD (ND-CKD) patients. The study was carried out using the cross sectional design. The subjects of the study consist of 45 ND-CKD patients and 45 healthy subjects matched for age, gender, height and body mass index (BMI). The nutritional status of patients and healthy subjects were classified based on BMI (WHO, 1995) into low, normal and high nutritional status groups. Fat free mass (FFM), FFM-index (FFM-I) and percentage of fat mass (FM percentage) in patients measured by anthropometric technique showed no significant difference with healthy subjects. Using the BIA method, FFM and FFM-I were significantly lower in the ND-CKD patients compared to the healthy subjects (p < 0,05). Significant difference in FFM, FFM-I, FM and FM percentage was observed between the patients with different nutritional status. (p < 0,001). Trend analysis statistical test showed that there is linear correlation of FFM, FFM-I and FM with nutritional status classification. FFM, FFM-I, FM and FM percentage in ND-CKD patients were not significantly different between the three stages of CKD. There was an acceptable degree of agreement between BMI with FFM-I for nutritional assessment in ND-CKD patients. The Receiver Operating Curve test showed the cut off points of FFM-I 14.23 kg/m2 to differentiate undernutrition and normal nutritional status in ND-CKD patients. This study showed FFM-I has good correlation with BMI and can be used to differentiate degrees of nutritional status in stage 3, 4 and 5 ND-CKD patients. FFM-I considered predictor parameters for nutritional status screening in ND-CKD patients.
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Estado Nutricional , Insuficiência Renal CrônicaRESUMO
OBJECTIVE To elucidate the hospital-acquired infections of chronic kidney disease non-dialysis patients and associated factors.METHODS Clinical data of 996 non-dialysis patients between Jun 1,2003 and Jun 1,2006 were enrolled in this retrospective study of hospitalized cases,there were 112 cases of hospital-acquired infections.The infection site,pathogens,renal function,serum albumin and hemoglobin were analyzed.RESULTS During above period 124 hospital-acquired infection episodes occurred.The infection rate was 11.2%,It was significantly higher than rate of hospital-acquired infection of our hospital at the same time(P