Beneficial effect of Astragalus membranaceus on estimated glomerular filtration rate in patients with progressive chronic kidney disease

SummaryBackground/PurposeSeveral types of herbal preparations have been used as supplementary therapies for the treatment of progressive chronic kidney disease (CKD), but the scientific evidence for their use is scarce. The aim of the present study was to determine the effects of Astragalus membranaceus on renal outcome in patients with progressive CKD.Methods and ResultsThe study population consisted of 35 patients with CKD stages 4 and 5 whose estimated glomerular filtration rate (eGFR) decreased over a 3-month period before the start of A membranaceus treatment despite the use of conventional therapy (from 14.6±6.28mL/min/1.73m2 to 11.6±5.24; mean±SD, p<0.05). Similarly, the eGFR of 15 patients with CKD stage 4 decreased over the same period despite conventional therapy (from 20.8±4.59 to 16.7±4.17; r=−1.298; p<0.05), but increased after the initial period of 3 months of supplementary treatment with A membranaceus (to 18.6±5.67; r=0.973; p<0.05) and remained at that level at 6 months (17.8±5.60) and 12 months (16.3±5.89). However, in 20 patients with CKD stage 5, the beneficial effect of A membranaceus was limited to the first 3 months only (−3 months: 10.5±2.7, baseline: 8.0±2.75, 3 months: 8.4±2.96, 6 months: 6.8±2.45). A membranaceus had no significant effects on other laboratory parameters. Only seven patients (1 in stage 4 and 6 in stage 5) required dialysis within 12 months of A membranaceus treatment, whose eGFR at baseline was relatively low (7.4±1.06).ConclusionThe results suggest that A membranaceus can maintain stable levels of eGFR and delay the initiation of renal replacement therapy in patients with progressive CKD stage 4.至今已有數種草藥製劑被應用於進行性慢性腎病(CKD)的補充療法，然而此用途仍缺乏相關的科學理據。本研究旨在探討膜莢黃耆(Astragalus membranaceus)對進行性CKD患者的腎臟效應。研究對象為35位第4或5期CKD患者，即使在常規治療下(不包括A membranaceus)，其腎絲球過濾率估算值(eGFR)仍在3個月內明顯下降(從14.6±6.28mL/min/1.73m2至11.6±5.24; mean±SD, p<0.05)。其中15人為第4期CKD患者，eGFR於該段期間明顯下降(從20.8±4.59至16.7±4.17; r=−1.298; p<0.05)，但在膜莢黃耆補充療法開始後3個月回升(至18.6±5.67; r=0.973; p