Efficacy and safety of Abelmoschus manihot for IgA nephropathy: A multicenter randomized clinical trial

Li, Ping; Lin, Hongli; Ni, Zhaohui; Zhan, Yongli; He, Yong; Yang, Hongtao; Fang, Jingai; Wang, Niansong; Li, Wenge; Cai, Guangyan; Chen, Yizhi; Zhang, Peiqing; Wang, Xiaoqin; Chen, Qinkai; Li, Zhenjiang; Sun, Xuefeng; Chen, Xiangmei

doi:10.1016/j.phymed.2020.153231

Cited by 32 publications

(30 citation statements)

References 33 publications

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“…A multicenter RCT showed that Huangkui capsule has antiproteinuric effect for patients with early stage primary glomerulonephritis, and the other multicenter, double-blind, double-dummy RCT also showed that it can effectively reduce proteinuria in patients with IgA nephropathy. Both RCTs showed that Huangkui capsule treatment has no obvious side effects [142,143]. Cai et al demonstrated that the Huangkui capsule reduced BUN and Scr in adenine-induced chronic renal failure (CRF) rats.…”

Section: Huangkui Capsulementioning

confidence: 99%

The Therapeutic Strategies for Uremic Toxins Control in Chronic Kidney Disease

Wei

et al. 2021

Toxins

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Uremic toxins (UTs) are mainly produced by protein metabolized by the intestinal microbiota and converted in the liver or by mitochondria or other enzymes. The accumulation of UTs can damage the intestinal barrier integrity and cause vascular damage and progressive kidney damage. Together, these factors lead to metabolic imbalances, which in turn increase oxidative stress and inflammation and then produce uremia that affects many organs and causes diseases including renal fibrosis, vascular disease, and renal osteodystrophy. This article is based on the theory of the intestinal–renal axis, from bench to bedside, and it discusses nonextracorporeal therapies for UTs, which are classified into three categories: medication, diet and supplement therapy, and complementary and alternative medicine (CAM) and other therapies. The effects of medications such as AST-120 and meclofenamate are described. Diet and supplement therapies include plant-based diet, very low-protein diet, probiotics, prebiotics, synbiotics, and nutraceuticals. The research status of Chinese herbal medicine is discussed for CAM and other therapies. This review can provide some treatment recommendations for the reduction of UTs in patients with chronic kidney disease.

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Section: Huangkui Capsulementioning

confidence: 99%

The Therapeutic Strategies for Uremic Toxins Control in Chronic Kidney Disease

Wei

et al. 2021

Toxins

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“…The results indicated that the effectiveness of Abelmoschus manihot was similar to losartan in reducing urinary proteins (Li, et al, 2020a). The eGFR was stable and did not show a significant decline in both treatment groups during the 48-weeks follow-up.…”

Section: Clinical Studiesmentioning

confidence: 80%

“…Abelmoschus manihot is one of the important drugs for the treatment of CKD. It has been reported that treatment with Abelmoschus manihot can reduce proteinuria and improve renal function in patients with diabetic kidney disease (DKD) ( Shi, et al, 2019 ), IgA nephropathy ( Li, et al, 2020a ), and CKD stages 1–2 ( Zhang, et al, 2014 ). In a meta-analysis identified 72 clinical investigations involving 5,895 participants.…”

Section: Abelmoschus Manihot and Huangkui Capsulementioning

confidence: 99%

New Insights Into the Effects of Individual Chinese Herbal Medicines on Chronic Kidney Disease

Shao

Bayliss

et al. 2021

Front. Pharmacol.

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The clinical and experimental study into the effects of Chinese herbal medicines on chronic kidney disease has evolved over the past 40 years with new insight into their mechanism and evidence of their clinical effects. Among the many traditional Chinese herbs examined in chronic renal disease, five were found to have evidence of sufficient clinical efficacy, high frequency of use, and well-studied mechanism. They are: Abelmoschus manihot and Huangkui capsule, Salvia miltiorrhiza and its components (tanshinone II A, salvianolic acid A and B); Rhizoma coptidis and its monomer berberine; Tripterygium wilfordii and its components (triptolide, tripterygium glycosides); Kudzu root Pueraria and its monomer Puerarin. These Chinese herbal medications have pharmaceutical effects against fibrosis, inflammation and oxidative stress and also promote renal repair and regeneration. This article reviews their clinical efficacy, anti-fibrotic effects in animal models, and molecular mechanism of action.

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“…In China, traditional Chinese medicines (TCMs) have an extensive history of application, and there is substantial literature on the treatment of IgAN with TCM. Furthermore, various TCM extracts or formulae have been demonstrated to have renal-protective effect ( Li et al, 2017 ; Yang et al, 2018 ; Bai et al, 2019a ; Bai et al, 2019b ; Li et al, 2020a ; Li et al, 2020b ; Li et al, 2020c ; Li and Li, 2020 ). Modified Huangqi Chifeng decoction, a compound formula in TCM, has been used to treat IgAN for several years.…”

Section: Discussionmentioning

confidence: 99%

Modified Huangqi Chifeng Decoction Attenuates Proteinuria by Reducing Podocyte Injury in a Rat Model of Immunoglobulin a Nephropathy

Chang

Yang

et al. 2021

Front. Pharmacol.

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Modified Huangqi Chifeng decoction (MHCD) has been used to reduce proteinuria in immunoglobulin A nephropathy (IgAN) for many years. Previously, we have demonstrated its protective role in glomerular mesangial cells. Podocyte injury, another key factor associated with proteinuria in IgAN, has also attracted increasing attention. However, whether MHCD can reduce proteinuria by protecting podocytes remains unclear. The present study aimed to investigate the protective effects of MHCD against podocyte injury in a rat model of IgAN. To establish the IgAN model, rats were administered bovine serum albumin, carbon tetrachloride, and lipopolysaccharide. MHCD in three doses or telmisartan was administered once daily for 8 weeks (n = 10 rats/group). Rats with IgAN developed proteinuria at week 6, which worsened over time until drug intervention. After drug intervention, MHCD reduced proteinuria and had no effect on liver and kidney function. Furthermore, MHCD alleviated renal pathological lesions, hyperplasia of mesangial cells, mesangial matrix expansion, and podocyte foot process fusion. Western blot analysis revealed that MHCD increased the expression of the podocyte-associated proteins nephrin and podocalyxin. Additionally, we stained podocyte nuclei with an antibody for Wilms’ tumor protein one and found that MHCD increased the podocyte number in rats with IgAN. In conclusion, these results demonstrate that MHCD attenuates proteinuria by reducing podocyte injury.

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Efficacy and safety of Abelmoschus manihot for IgA nephropathy: A multicenter randomized clinical trial

Cited by 32 publications

References 33 publications

The Therapeutic Strategies for Uremic Toxins Control in Chronic Kidney Disease

The Therapeutic Strategies for Uremic Toxins Control in Chronic Kidney Disease

New Insights Into the Effects of Individual Chinese Herbal Medicines on Chronic Kidney Disease

Modified Huangqi Chifeng Decoction Attenuates Proteinuria by Reducing Podocyte Injury in a Rat Model of Immunoglobulin a Nephropathy

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