Insights & Discussion
Chinese herbal medicine may be effective and safe for treating diabetic kidney disease, although evidence quality varies.
The systematic review and meta-analysis comprised randomized controlled trials comparing the use of oral Chinese herbal medicine (CHM) to a placebo, involving a comprehensive search strategy and selecting from over 7000 articles, resulting in 20 studies with a total of 2719 participants. Potential bias was minimized by only including studies that pitted CHM against a placebo. In addition, an a priori subgroups analysis was conducted to identify potential candidate formulae and frequently used herbs for further exploration.
Despite these measures, the overall evidence ranged from moderate to very low quality due to unclear randomization procedures, substantial variations in outcome measures, and reduced external validity. The latter was affected by factors such as multi-ingredient herbal formulae, brief follow-up periods, limited numbers of clinical events, and the inclusion of older patients with less advanced disease.
Discover Related Insights
Berry fruits such as blueberries, cranberries, raspberries, and strawberries could potentially improve gut microbiota and reverse dysbiosis in chronic kidney disease patients.
2023 Nutrition Reviews Blueberry, cranberry, raspberry, and strawberry as modulators of the gut microbiota: target for treatment of gut dysbiosis in chronic kidney disease? From current evidence to future possibilities Coutinho-Wolino KS, Melo MFS, Mota JC, Mafra D, Guimarães JT, Stockler-Pinto MB
Review Article Blueberry Chronic Kidney Disease Cranberry
Methodology: This research explores the therapeutic potential of berry fruits, including blueberries, cranberries, raspberries, and strawberries, in relation to modulating gut microbiota in chronic kidney disease (CKD) patients. The fruit’s rich polyphenol and nutrient content are assumed to promote the selective growth of beneficial bacteria, thus improving the clinical status of these patients. The study scrutinizes the impact on the abundance of mucus-producing bacteria and short-chain fatty acids specifically.
Discussion of Results: The gathered evidence illustrates that berry fruits, particularly with a daily intake of 5 mg, can promote diversity in the gut microbiota and possibly reverse dysbiosis, a common issue in chronic kidney disease patients. These fruits are found to increase the expression of mRNA involved in gut tight junctions such as occludin, TJP1, and mucin, and they may reduce uremic toxins by controlling the gut microbiota, improving the uremic condition. As such, long-term use of berry fruits could be an effective strategy for CKD patients.
The herbal decoction Jian-Pi-Yi-Shen reduces symptoms of chronic kidney disease and anaemia by improving iron metabolism and inhibiting the JAK2-STAT3 signaling pathway.
2023 Journal of Ethnopharmacology Jian-Pi-Yi-Shen formula restores iron metabolism from dysregulation in anemic rats with adenine-induced nephropathy Li C, Huang H, Wang R, Zhang C, Huang S, Wu J, et al.
Experimental Study Anaemia Chronic Kidney Disease Jian Pi Yi Shen Formula
Methodology used included an analysis of network pharmacology, chemical profiling, and in vivo experiments on the effect of Jian-Pi-Yi-Shen (JPYS) on renal anemia and chronic kidney disease (CKD). The active compounds in JPYS were detected in in vivo experiment, and their potential targets were predicted by network pharmacology. An animal model of CKD-related anemia was developed using adenine-feeding for further analysis. The estimation of renal injury was conducted using blood tests, histopathological examinations, and fibrosis degree assessment while the levels of JAK2, STAT3 and iron metabolism-related factors were measured through various techniques.
Discussion of the results reveals that 164 active ingredients, including prototypes and metabolites in JPYS, were discovered and 21 core targets were identified. Many of these core targets were associated with the JAK2-STAT3 signaling pathways. Experimental results demonstrated that JPYS treatment significantly improved hematological parameters and iron metabolism in CKD rats, decreased certain indicators of renal damage, and suppressed the expression of JAK2 and STAT3.
Jian-Pi-Yi-Shen formula has shown potential in delaying kidney deterioration in chronic kidney disease by rejuvenating the process of creating nicotinamide adenine dinucleotide.
2023 Aging Jian-Pi-Yi-Shen formula alleviates renal fibrosis by restoring NAD+ biosynthesis in vivo and in vitro Gao L, Huang X, Deng R, Wu S, Peng Y, Xiong G, et al.
Experimental Study Chronic Kidney Disease Jian Pi Yi Shen Formula Renal Fibrosis
The study was conducted utilizing an adenine-diet feeding model for inducing chronic kidney disease in a breed of mice. For 4 weeks, these mice were given Jian-Pi-Yi-Shen formula orally. Human proximal tubular epithelial cells were stimulated with a growth factor, with or without the formula. Assessments were made of renal function via serum creatinine and blood urea nitrogen levels, with renal histopathological changes evaluated through specific staining techniques. Further, cell viability and NAD+ concentrations were monitored with assay kits.
The Jian-Pi-Yi-Shen formula did not only help in the improvement of renal function and reduction of pathological injury but it also inhibited renal fibrosis in the mice with chronic kidney disease. Moreover, the same formula was found to reverse fibrotic responses induced by a growth factor in human proximal tubular epithelial cells. Importantly, the formula was observed to recover the decreased NAD+ content in the chronic kidney disease mice and the human cells, bringing about the restoration of the expression of vital enzymes in the NAD+ synthesis process.
Various traditional Chinese medicine treatment strategies could potentially provide an effective alternative in slowing the progression of Chronic Kidney Disease.
2022 Frontiers in Pharmacology Traditional Chinese Medicine in the Treatment of Chronic Kidney Diseases: Theories, Applications, and Mechanisms Yunlai Wang, Ye Feng, Manman Li, Mo Yang, Gaoxiang Shi, Zihua Xuan, et al.
Review Article Chronic Kidney Disease Dan Shen Dang Gui
The study explores the use of Traditional Chinese Medicine (TCM) and various Chinese materia medica (CMM) to manage Chronic Kidney Disease (CKD). The review delves deeper into the principles and treatment approaches of TCM in battling CKD, dictating that the disease's nature is deficient in the root and excessive in the branches, where deficiency and excess persist simultaneously throughout the condition. The main strategies employed by TCM in the treatment of CKD include invigorating Qi, tonifying kidneys, promoting blood circulation, removing stasis, eliminating heat and dampness, reducing turbidity, and controlling edema.
The discussion highlights the effectiveness of several CMMs in treating CKD, which are undergirded by clinical evidence or experimental studies. Notably, it points out a correlation between the macroscopic view of TCM and the microscopic view of modern medicine. These TCM and CMM strategies are hailed for their multi-targeted and multi-functional characteristics, potentially providing an effective alternative treatment approach for CKD.
The Jian Pi Yi Shen formula in traditional Chinese medicine demonstrates a protective effect on kidneys by modulating tryptophan metabolism and Aryl hydrocarbon receptor activation.
2022 Frontiers in Pharmacology Jian-Pi-Yi-Shen Formula Improves Adenine-Induced Chronic Kidney Disease via Regulating Tryptophan Metabolism and Aryl Hydrocarbon Receptor Signaling Liu X, Deng R, Chen Y, Huang S, Lu J, Zheng L, et al.
Network Pharmacology Chronic Kidney Disease Jian Pi Yi Shen Formula Tryptophan
A chronic kidney disease (CKD) rat model was induced by feeding a diet containing 0.75% adenine over a four-week period. Concurrently, the Jian-Pi-Yi-Shen formula was administered every day starting from the third week and continued for four additional weeks. Multiple factors were evaluated including renal injury, fibrotic markers expression, and serum creatinine and blood urea nitrogen levels. The levels of 10 tryptophan metabolites in the rat serum and Aryl hydrocarbon receptor signaling were detected and analyzed using ultra-high performance liquid chromatography-tandem mass spectrometry and Western blot analysis, respectively.
The Jian-Pi-Yi-Shen formula demonstrated significant effects of reducing both serum creatinine and blood urea nitrogen levels and improving renal pathological injuries in the CKD rat model. It was found that the formula also regulated tryptophan metabolism and decreased the levels of tryptophan metabolites in the serum. Furthermore, the formula suppressed the overactivated Aryl hydrocarbon receptor signaling in the kidney. These observations imply that the actions of the Jian-Pi-Yi-Shen formula could effectively protect against CKD.
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