Treatment of Primary Chronic Glomerulonephritis with Rehmannia Glutinosa Acteosides in Combination with the Angiotensin Receptor Blocker Irbesartan: A Randomized Controlled Trial

Abstract

This study aims to assess the efficacy and safety of Rehmannia glutinosa acteosides used in combination with the angiotensin receptor blocker irbesartan to treat primary chronic glomerulonephritis. A total of 479 patients diagnosed with primary chronic glomerulonephritis were recruited from outpatient clinics and were randomly assigned to the treatment group (Rehmannia glutinosa acteosides, two 200-mg capsules, bid; and irbesartan, one 150-mg tablet, qd) or the control group (irbesartan, one 150-mg tablet, qd). The primary outcome was 24-h urinary protein. Secondary outcome measures included blood pressure, estimated glomerular filtration rate, erythrocyturia, serum alanine aminotransferase, aspartate transaminase and electrolytes. After 8 weeks of treatment, the treatment group showed a mean reduction in 24-h proteinuria of 36.42% compared to baseline, which was significantly higher than the mean reduction from baseline of 27.97% in the control group (P = 0.0278).Adverse drug reactions occurred at a similarly low rate in the treatment group (0.4%) and control group (1.2%, P = 0.3724). In the treatment of chronic glomerulonephritis, the combination of Rehmannia glutinosa acteosides and irbesartan can reduce proteinuria more effectively than irbesartan alone.

Acteoside relieves mesangial cell injury by regulating Th22 cell chemotaxis and proliferation in IgA nephropathy

“…Hong et al. have proved that urinary protein levels were more effectively controlled in patients with chronic nephritis treated with Rehmannia glutinosa acteoside and irbesartan compared with irbesartan [ 13 ], but the effect of acteoside in IgAN is unknown.…”

The potential therapeutic use of renin–angiotensin system inhibitors in the treatment of inflammatory diseases

“…A 6-year randomized trial in IgA nephritis showed that high dose losartan (200 mg/day) was more efficacious in reducing proteinuria as well as preserving renal function when compared with normal dose losartan (100 mg/day) and enalapril (20 mg/day; Woo et al, 2008). In a randomized controlled trial conducted by Qiu et al (2014), irbesartan significantly reduced proteinuria in 479 patients with primary chronic glomerulonephritis. However, its combination with Rehmannia glutinosa acteosides yielded a greater reduction in proteinuria.…”

BDNF and COX-2 participate in anti-depressive mechanisms of catalpol in rats undergoing chronic unpredictable mild stress

“…The dry root of Rehmannia glutinosa Libosch (Scrophulariaceae) has been widely used as a traditional Chinese herbal medicine for neuroprotection, immune enhancement, hepatoprotection, prevention of bone loss, and treatment of primary chronic glomerulonephritis, learning and memory impairment, and anti-depression [24][25][26][27][28][29]. Catalpol, a major bioactive compound enriched by the dried root of R. glutinosa with the chemical structure previously shown [30], has been found to demonstrate broad and diverse bioactivities including neuroprotection, ameliorating cognition deficits and diabetic encephalopathy, potentially attenuating inflammation-related neurodegenerative diseases, protection against cerebral and cardiac ischemia/reperfusion injury, hepatoprotection, and radioprotection [31][32][33][34][35][36][37].…”