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Keywords. Achillea, chronic kidney disease, nitric oxide, hemorrhage
Introduction. Increased plasma nitric oxide concentration has been supposed as one of the possible mechanisms of bleeding tendency in patients who suffer chronic kidney disease. Nitric oxide-scavenging properties have been reported with some Achillea species. This study was designed to find any possible effect of Achillea millefolium on plasma nitric oxide concentration in these patients.
Materials and Methods. Thirty-one chronic kidney disease patients were included in this randomized controlled trial, of whom16 received 1.5 g of powdered A millefolium flower 3 days a week for 2 months, and 15 received placebo for the same period. Plasma samples were collected before and after the study period to estimate the effect of A millefolium on plasma nitric oxide metabolites (nitrite and nitrate).
Results. Although not statistically significant, plasma nitrite and nitrate concentrations decreased after 2 months' administration of A millefolium (0.82 ± 0.51 µmol/L to 0.63 ± 0.42 µmol/L and 50.55 ± 17.92 µmol/L to 44.09 ± 17.49 µmole/L, respectively). These concentrations were slightly increased in the placebo group after the study period.
Conclusions. Countercurrent to the placebo group, plasma nitric oxide metabolites were marginally decreased after A millefolium administration in chronic kidney disease patients. Higher doses or longer duration of plant administration may make these changes more significant.
IJKD 2012;6:350-4
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INTRODUCTION
Amongst many complications associated with chronic kidney disease (CKD), uremic bleeding is a well-known syndrome caused by multiple factors, including platelet dysfunction. While there are reports of nitric oxide (NO) deficiency in CKD patients,1 some strongly suggest that the plasma concentration of NO is higher in uremic patients compared to nonuremic ones.2 Some investigations propose that excessive NO production may inhibit platelet aggregation.2, 3
Numerous treatment methods have been suggested to manage uremic bleeding. Among them administration of conjugated estrogens is proved to be a safe and effective method. Although the exact mechanism by which estrogen corrects bleeding tendency in uremia is still unclear, it has recently been suggested that 17β-estradiol (the most active component) reduces the concentration of NO by decreasing its production.4,5
Use of medicinal plants dates back to ancient times. Herbal medicine provides plentiful alternatives to synthetic compounds in the treatment of almost any condition, as it is believed to be...