Albuminuria ; drug therapy ; Diabetes Mellitus, Type 2 ; complications ; drug therapy ; Diabetic Nephropathies ; drug therapy ; Humans ; Tetrazoles ; therapeutic use

OBJECTIVEIn order to explore the therapeutic effect of tongxinluo capsule (TXLC) on diabetic nephropathy, the influence on plasma endothelin (ET-1) level of the drug was observed.

METHODSAll the 63 patients enrolled were randomly divided into the treatment group and control group. They were all treated with low protein diabetic diet, oral administration of hypoglycemic or injection of insulin, calcium antagonist according to level of blood pressure and supportive symptomatic treatment. To the treated group, 2 capsules of TXLC were given additionally three times a day. The efficacy was evaluated after 8 weeks' treatment. The chief indices observed before and after treatment were endogenous creatinine clearance rate (CCr), urinary albumin excretion rate (UAER), urinary beta2-microglobulin (beta2-MG), fasting blood-glucose (FBG) and ET-1.

RESULTSBefore treatment, no significant difference was shown in all the tested indices between the treated group and the control group. After treatment, levels of CCr, UAER, beta2-MG, ET-1 and FBG significantly changed in the treated group, showing significant difference as compared with those before treatment (P < 0.05). Moreover, comparison of these indices in the two groups after treatment, excepting FBG, also showed statistical significance (P < 0.01).

CONCLUSIONTXLC shows obvious effect in reducing plasma ET-1 and UAER, it is definitely effective in repairing the renal tubular interstitial damage, and effectively delay the progress of diabetic nephropathy, improve the renal function, and is favorable to ameliorate hyperglycemia auxiliarily.

Albuminuria ; urine ; Capsules ; Diabetic Nephropathies ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Endothelin-1 ; blood ; Female ; Humans ; Male ; Phytotherapy

OBJECTIVETo observe the effects of Xiaobai Decoction (XBD) in reducing albuminuria and shortening the duration of albuminuria in patients with pregnancy-induced hypertension syndrome (PIH) in puerperium.

METHODSEighty-five patients were given the conventional treatment with magnesium sulfate for relieving convulsion and lowering hypertension, at the same time, the treated group was given XBD additionally with the modification according to the symptoms. The treatment course for both groups was 14 days. Routine test of midstream urine was performed every three days, and 24 h-urinary protein was measured every week.

RESULTSThe therapeutic effect on the 43 patients of the treated group was markedly effective in 11 (25.6 % ), effective in 26 (60.4%) and ineffective in 6 cases (14.0%), the total effective rate being 86.0%; while in the 42 patients of the control group, the corresponding numbers were 5 (11.9%), 21 (50.0%), 16 (38.1%) and 61.9%, respectively, the efficacy of the former was significantly better (P < 0.05).

CONCLUSIONXBD is a simple, safe and effective drug for reducing albuminuria and shortening the duration of albuminuria in puerperium of PIH patients.

Adult ; Albuminuria ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypertension, Pregnancy-Induced ; drug therapy ; Phytotherapy ; Postpartum Period ; Pregnancy ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the therapeutic effect of prostaglandin E1 (PGEl) on diabetic nephropathy (DN) after a one-year treatment.

METHODSAccording to Mogensen DN diagnostic criteria, the patients were divided into DN stages III, IV and V groups. Patients in stage IV nephropathy were subdivided into three groups according to the proteinuria, namely early stage IV (protienuria less than 1.5 g/day), mid-stage IV (protienuria between 1.5 and 2.5 g/day) and late stage IV (protienuria above 2.5 g/day). The patients were randomly given PGEl, PGEl plus angiotensin-converting enzyme inhibitor (ACEI), ACEI mono-therapy or basal treatment (control group). Proteinuria and albuminuria were measured before and at 15 days and 1 year of the treatment.

RESULTSIn the patients in DN stages III and early stage IV, proteinuria and albuminuria decreased significantly after 15 days and 1 year of treatment with PGEl+ACEI and PGEl (P<0.01), and the decrements were greater than that in patients receiving ACEI only (P<0.01 or P<0.05). In the patients in mid- and late stage IV nephropathy, proteinuria and albuminuria decreased significantly in PGEl+ACEI group after 15 days and 1 year of treatment (P<0.01), showing greater decrement than in ACEI group (P<0.01 ). Proteinuria and albuminuria decreased significantly in PGEl group after 15 days of treatment (P<0.01), but remained higher than that in ACEI group at one year (P<0.05). In the patients with stage V nephropathy, significant proteinuria and albuminuria reduction occurred in PGEl+ACEI and PGEl groups at 15 days (P<0.01) with a greater decrement than that in ACEI group (P<0.01 or P<0.05). In PGEl+ACEI group, proteinuria and albuminuria showed no significant changes at one year but were lower than those in ACEI group (P<0.05). Proteinuria and albuminuria increased significantly in ACEI and PGEl group after the treatment but were comparable between the two groups (P<0.05).

CONCLUSIONSThe therapeutic effects are much better in patients with stage III nephropathy than in those in stage V. The combination of PGEl and ACEI produces stronger therapeutic effects than PGE1 or ACEI alone even at the one-year follow up.

Adult ; Aged ; Albuminuria ; urine ; Alprostadil ; therapeutic use ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Diabetic Nephropathies ; drug therapy ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged

OBJECTIVETo study the effects of Fengbei Huayu recipe (FHR) on urinary albumin excretion rate (UAER) in patients with diabetic nephropathy (DN).

METHODSSeventy-two type 2 DN patients in III or IV stage were randomly divided into two groups, 36 in each group. All patients were treated with conventional hypoglycemic agents and hypotensor, but those in the treated group were given additionally with FHR twice a day for 8 successive weeks. The changes of UAER, D-polymer, glycosylate hemoglobin (HbA1c), renal function indexes, including blood urea nitrogen (BUN) and serum creatinine (SCr), and blood lipids, including total cholesterol (TC) and triglyceride (TG) in the two groups before and after treatment were compared.

RESULTSThe levels of UAER, D-polymer, HbA1c, TC and TG were significantly decreased after treatment in the treat- ed group (P < 0.05), and the improvement were superior to those in the control group (P <0.05) respectively. But the difference of renal function before and after treatment showed no significance in both groups.

CONCLUSIONFHR could not only obviously decrease the level of UAER, but also decrease the levels of blood glucose and blood-lipids in patients with DN.

Adult ; Aged ; Albuminuria ; drug therapy ; Diabetes Mellitus, Type 2 ; drug therapy ; Diabetic Nephropathies ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypoglycemic Agents ; therapeutic use ; Male ; Middle Aged ; Phytotherapy

OBJECTIVETo investigate the therapeutic effect of milkvetch injection (MI) combined with Captopril on early diabetic nephropathy (EDN).

METHODSA total of 69 EDN patients were randomly divided into three groups, with 23 in each group. Besides the conventional hypoglycemic therapy, patients in Group A Captopril, in Group B MI plus Captopril and in Group C MI were given respectively. The therapeutic course for all was 3 months. The related indices of EDN before and after treatment were measured and compared.

RESULTSAfter treatment, the blood pressure significantly lowered after treatment in Group A and B (P<0.01), but unchanged in Group C; the levels of blood glucose and HbA1c significantly decreased in Group B and C (P < 0.05 or P<0.01), and significant difference was shown in comparison of Group B with Group A (P<0.05); levels of 24hrs urinary albumin excretion (UAER), blood urea nitrogen (BUN) and serum creatinine (SCr) significantly decreased in all 3 groups, and the decrement in Group B was more significant than that in the other two groups (P <0.05).

CONCLUSIONMI combined with Captopril can not only decrease blood pressure, blood glucose and HbA1c, but also significantly decrease the UAER in treating EDN.

Adult ; Aged ; Albuminuria ; drug therapy ; Astragalus membranaceus ; Captopril ; therapeutic use ; Diabetes Mellitus, Type 2 ; drug therapy ; Diabetic Nephropathies ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Injections ; Male ; Middle Aged ; Phytotherapy

OBJECTIVETo explore the TCM therapy for puerperal albuminuria (PA) in patients with gestational hypertension syndrome (GHS).

METHODSSeventy-two GHS patients with PA in the severe preeclampsia stage were assigned to the treated group (38 cases) and the control group (34 cases). They were treated, starting from the postpartum second day, with Nifedipine 10 mg three times per day, but to the treated group, Shenkangbao (SKB, a TCM patent drug for stasis resolving and dinresis) was given additionally at the dose of 10 g twice a day, 3 weeks as one therapeutic course for all. Changes of urinary albumin quality and quantity, plasma total protein and albumin, as well as renal function and blood pressure before and after treatment were observed.

RESULTSSignificant difference after treatment between the two groups was shown in terms of percentage of cases with positive albuminuria (0.7 +/- 0.8 vs. 1.5 +/- 0.9), 24-h urinary albumin (520 +/- 480 mg vs. 1352 +/- 861 mg), plasma total protein (74.5 +/- 6.3 g/L vs. 67.8 +/- 6.2 g/L), and plasma albumin (39.4 +/- 4.5 g/L vs. 34.6 +/- 4.3 g/L, all P < 0.01); also in urinary albumin negative inversion rate (92.1% vs. 67.6%, P < 0.01). No significant difference of renal function between groups, and between pre- and post-treatment was found (P > 0.05), as for the blood pressure, it showed a significant difference between pre- and post-treatment in both groups (P < 0.01), but with no difference between groups (P > 0.05).

CONCLUSIONTCM therapy for stasis-resolving and diuresis with SKB can promote the eliminating of albuminuria in puerpera in the severe preeclampsia stage.

Adult ; Albuminuria ; drug therapy ; etiology ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypertension, Pregnancy-Induced ; drug therapy ; Medicine, Chinese Traditional ; methods ; Nifedipine ; therapeutic use ; Phytotherapy ; Postpartum Period ; Pre-Eclampsia ; drug therapy ; Pregnancy ; Young Adult

OBJECTIVETo observe the effect of combined therapy with Bailing Capsule (BC) and benazepril on the levels of urinary albumin excretion rate (UAER) and C-reactive protein (CRP) for exploring its protective effect on early diabetic nephropathy.

METHODSSixty patients with early diabetic nephropathy were randomly assigned to the control group treated by benazepril alone, and the treated group treated by BC and benazepril, and the treatment lasted for 16 weeks. The changes of UAER and CRP levels were measured to estimate the protective effect of the combined therapy.

RESULTSLevels of 24h urinary protein, UAER, CRP were (0.85 +/- 0.32) g/24 h, (83.34 +/- 38.27) microg/min, (2.67 +/- 1.72) mg/L before treatment in the control group, and (0.43 +/- 0.17) g/24 h, (71.22 +/- 31.12) microg/min, (1.05 +/- 0.78) mg/L after treatment and they were (0.87 +/- 0.31) g/24 h, (81.59 +/- 35.69) microg/min, (2.55 +/- 1.66) mg/L before treatment in treated group, and (0.25 +/- 0.29) g/24 h, (57.32 +/- 31.11) microg/min, (0.49 +/- 0.38) mg/L after treatment respectively, all of them decreased after treatment in both groups, showing significant differences as compared with those before treatment (P<0.05, P< 0.01), and the reduction in the treated group was more significant (P<0.01); meanwhile, levels of serum creatinine, fasting blood glucose and HbA1c had somewhat decrease, showing no statistical difference with those before treatment (P >0.05).

CONCLUSIONCombined use of BC and benazepril could significantly lower the UAER and CRP levels in patients with early diabetic nephropathy to alleviate the renal impairment, showing an effect better than that of using benazepril alone.

Adult ; Aged ; Albuminuria ; drug therapy ; Benzazepines ; therapeutic use ; C-Reactive Protein ; metabolism ; Diabetes Mellitus, Type 2 ; drug therapy ; metabolism ; urine ; Diabetic Nephropathies ; drug therapy ; metabolism ; urine ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy

PURPOSE: Oxidative stress has been suggested to play a role as a common mediator of apoptosis and kidney damage in diabetes. However, it is uncertain whether the apoptosis occurs in the kidney during the course of diabetes. We investigated the occurrence of apoptosis in the diabetic rat kidney, the role of oxidative stress and the effect of an antioxidant on apoptosis in the diabetic rat kidney. MATERIALS AND METHODS: Otsuka-Long-Evans-Tokushima-Fatty rats, an animal model for type 2 diabetes, were randomized into a non-treated diabetic (n=8) and a vitamin C-treated group (n=8). Long-Evans Tokushima Otsuka rats (n=8) were used as a control. RESULTS: Apoptosis was present in the epithelial cells of the proximal tubules in diabetic rats. The number of apoptotic cells, albuminuria, proteinuria, glomerular and tubulointerstitial sclerosis, and renal malondialdehyde were significantly decreased in vitamin C-treated diabetic rats when compared to the untreated diabetic rats. The decreased slit pore density (number of slit pores per underlying glomerular basement membrane length) as assessed by electron microscopy was also significantly restored by treatment with vitamin C without significantly affecting plasma glucose in diabetic rats. CONCLUSION: By blocking these pathophysiologic processes, a blockade of oxidative stress by vitamin C might become a useful adjunct to albuminuria and renal sclerosis in diabetic nephropathy.
Albuminuria/*drug therapy ; Animals ; Antioxidants/*therapeutic use ; Apoptosis/drug effects ; Ascorbic Acid/*therapeutic use ; Diabetes Mellitus, Experimental/*drug therapy/pathology ; Diabetic Nephropathies/*drug therapy/pathology ; Kidney/*pathology ; Male ; Oxidative Stress/*drug effects ; Rats ; Rats, Inbred OLETF ; Sclerosis

OBJECTIVETo observe the effect of Compound Fructus Arctii Mixture (FAM, consisted of Fructus Arctii and ethanol extract of Radix Astragalus membranaceus) in treating diabetic nephropathy.

METHODSUsing FAM to treat 31 patients with diabetic nephropathy and controlled by 23 patients treated with Losartan, the therapeutic course was 3 months for both groups, changes of clinical symptoms, blood glucose, lipid metabolism and urinary albumin were observed and compared.

RESULTSThe total effective rate in the treated group was 80.6% while in the control group 65.2%. The symptoms, urinary protein and albumin as well as lipid metabolism in the treated group all significantly improved after treatment (P<0.05), but in the control group improvement only showed in urinary albumin level (P<0.05).

CONCLUSIONFAM has the effects of reducing urinary protein in 24 hrs, lowering urinary albumin, improving blood glucose after meal and lipid metabolism.

Adult ; Albuminuria ; drug therapy ; Astragalus membranaceus ; Diabetic Nephropathies ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Female ; Furans ; therapeutic use ; Glucosides ; therapeutic use ; Humans ; Losartan ; therapeutic use ; Male ; Middle Aged ; Phytotherapy