Clinical effects of the oral administration of Astragali Radix extract in patients with chronic kidney disease

Abstract

Background

The decline in glomerular filtration rate is an unfortunate consequence of chronic kidney disease (CKD). People diagnosed with CKD are limited to managing the illness with a combination of lifestyle changes and pharmaceutical agents that target the renin–angiotensin–aldosterone system pathway. Researchers are investigating the potential of herbal agents, such as Astragali Radix, as treatment options in CKD. However, few studies have investigated this compound, and even fewer have examined the oral administration of the compound concerning its significance in bioavailability, as well as realistic compliance of daily medicinal use among potential users. We investigated the clinical effects of the oral administration of Astragali Radix as a renoprotective medicinal agent.

Methods

A total of 16 participants with an estimated glomerular filtration rate (eGFR) < 45 mL/min/1.73 m² (CKD stage 3b) were included in the study. Approximately 10 g per day of Astragali Radix was mixed with 200 mL of water and infused by heating until the volume was reduced to 100 mL, which was set as the daily dose. All patients continued to take the Western pharmacological agents after initiating adjunctive treatment with Astragali Radix. The Benjamini–Hochberg (false discovery rate (FDR) correction) method and paired t-test were used to compare each participant’s baseline eGFR with their follow-up eGFR at 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, and 5 years after adjunctive treatment with oral Astragali Radix extract.

Results

After starting Astragali Radix treatment, the mean eGFR of the subjects significantly increased from 34.3 ± 5.3 to 45.5 ± 10.7 mL/min/1.73 m² at 1 year (15 cases); 46.2 ± 10.5 mL/min/1.73 m² at 2 years (14 cases); 45.0 ± 10.0 mL/min/1.73 m² at 3 years (13 cases); and 42.2 ± 8.5 mL/min/1.73 m² at 5 years (11 cases). Only one case showed increased urine protein levels during the 5-year study period, while urine protein levels of other individuals did not increase. The major side effects of taking Astragali Radix were skin rash and an urticaria-like allergic reaction, which was observed in three excluded participants in the initial period.

Conclusions

These results suggest that Astragali Radix can preserve and potentially improve long-term eGFR in patients with CKD stage G3b or G4. Astragali Radix may be an option for treating CKD mainly caused by diabetes or hypertension.