Effect of Rong Huang granules of patients with non-dialysis kidney deficiency damp heat syndrome and chronic kidney disease mineral and bone metabolism disorder to serum OPG and RANKL levels / 中国免疫学杂志

ABSTRACT

Objective:To observe serum osteoprotegerin (OPG),receptor activator of NF-kB ligand (RANKL) levels and the therapeutic effect of Rong Huang granules of patients with non-dialysis chronic kidney disease mineral and bone metabolism disorder (CKD-MBD) and kidney deficiency damp heat syndrome.Methods:70 cases of non-dialysis CKD-MBD with kidney deficiency damp heat syndrome,were randomly divided into treatment group and control group,the actual completion of 61 cases,30 cases in treatment group,31 cases in the control group;and a healthy normal group of 20 cases of patients was established.Two groups of patients were given symptomatic treatment,in addition,Rong Huang granules was plused in treating at treatment group and it was used three times a day,each time blunt one bag.The course of treatment was 8 weeks.The changes of kidney deficiency damp heat syndrome,blood urea nitrogen (BUN),serum creatinine (Scr),estimated glomerular filtration rate (eGFR),serum of calcium (Ca),phosphorus (P), alkaline phosphatase (ALP),parathyroid hormone (iPTH),OPG and RANKL levels were observed in two groups of patients.Results:The total effective rate in treatment group was significantly better than the control group(P<0.01).The integral value of syndrome decreased more significantly with the course of treatment increased of two groups of patients(P<0.01).Compared with the same period of therapy,the descender in the treatment group was significantly better than that in the control group(P<0.01).The levels of BUN, Scr,eGFR,Ca,P,iPTH and ALP were improved in the treatment group after treatment(P<0.05 or P<0.01),BUN and iPTH were improved in the control group(P<0.05 or P<0.01),other indexes were not improved(P>0.05).After treatment,BUN,Scr,eGFR,Ca, P,iPTH,ALP of treatment group were significantly better than the control group(P<0.05 or P<0.01).Compared with the normal group,the levels of OPG and RANKL were significantly higher in CKD-MBD patients (P<0.01).After treatment,serum OPG level, serum RANKL level and OPG/RANKL ratio were significantly improved than before treatment in treatment group(P<0.05 or P<0.01),and in the control group,only the OPG/RANKL ratio increased(P<0.01).After treatment,OPG,RANKL and OPG/RANKL ratio in the treatment group were obviously improved compared with them in the control group(P<0.05 or P<0.01).Conclusion:The levels of OPG and RANKL in non-dialysis CKD-MBD patients with kidney deficiency damp heat syndrome were higher than those in healthy people,and the ratio of OPG/RANKL was lower than that in healthy people.Rong Huang granules can ameliorate clinical symptoms,prevent calcium and phosphorus metabolism,improve renal function,the mechanism may be related to the ameliorate of serum OPG and the decrease of serum RANKL level and the raise of ratio of OPG/RANKL.