Effect Of Rong Huang Tonify Kidney Detoxifica Tion Granules On The Serum OPG、RANKL Of Non Dialysis CKD-MBD Patients With Kidney Deficiency Damp Heat Syndrome

Objective This topic by observing serum osteoprotegerin (OPG), receptor activator of NF-κB ligand (RANKL) levels and the therapeutic effect of Rong Huang tonify kidney detoxification granules of patients with non-dialysis chronic kidney disease mineral and bone metabolism disorder(CKD-MBD) and kidney deficiency damp heat syndrome,designed to investigate the therapeutic effect of CKD-MBD and the possible mechanism of Rong Huang tonify kidney detoxification granules.Methods Choose 70 patients of non-dialysis CKD-MBD with kidney deficiency damp heat syndrome who met the inclusion criteria.Randomly divided them into observation group and control group.each of 35 cases. In the course of treatment, nine patients were loss of follow-up, including five patients of observation group and four patients of control group. Finally the actual completion was 61 cases of patients. And a healthy normal group of 20 cases of patients was established. Corresponding symptomatic treatment like depressurization, correction of anemia, correction of calcium and phosphorus metabolism disorder, suppression of secondary hyperparathyroidism and so on were given in both groups. In addition,Rong Huang tonify kidney detoxification granules was plused in treating at observation group and it was used three times a day, each time blunt one bag. The course of treatment was 8 weeks in two groups.The changes of kidney deficiency damp heat syndrome, renal function and other indicators and adverse reaction conditions were observed, and to detect the changes of serum of calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), parathyroid hormone (iPTH), OPG and RANKL levels before and after treatment of two groups of patients. At the same time, the serum levels of OPG and RANKL were detected in the normal group.Then according to the results of the experiment to determine the efficacy and statistical treatment.Results The curative effect and kidney deficiency damp heat syndrome as well as the main symptoms of patients in the observation group were better than the patients in the control group, and the difference was statistically significant((P<0.05 or P<0.01). The integral value of kidney deficiency damp heat syndrome decreased more significantly with the course of treatment increased of two groups of patients after treatment (P<0.01), compared with the same period of therapy, The descender in the observation group was significantly better than that in the control group(P<0.05 or P<0.01). After treatment, BUN, Scr, eGFR of observation group make an improvement than that before treatment(P<0.05 or P<0.01);and only BUN in the control group make improve ment than before treatment(P<0.05), Scr and eGFR in the control group has nosignificant improvement(P>0.05).Compared with the control group, the observation group improved significantly, and the difference was statistically significant(P<0.05). After treatment, Ca, P, iPTH, ALP of observation group were better than that before treatment(P<0.05 or P<0.01). Only iPTH of control group make an improvement than that before treatment (P<0.01). Ca, P and ALP in the control group has no significant improvement(P>0.05). Above indicators in the observation group improved significantly compared to the control group(P<0.05). The OPG and RANKL level in two groups of patients was significantly higher than the normal group before treatment(P<0.01), and between the two groups of patients, there was no significant difference(P>0.05). After treatment, serum OPG level, serum RANKL level and OPG/RANKL ratio were significantly improved than before treatment in observation group(P<0.05 or P<0.01), and in the control group, only the OPG/RANKL ratio increased(P<0.01). After treatment, OPG, RANKL and OPG/RANKL ratio in the observation group were obviously improved compared with them in the control group, and the differences between the two groups were statistically significant(P<0.05 or P<0.01). Pearson method was used to analyze:serum OPG, serum RANKL are significantly negative correlation with eGFR. and ALP, iPTH are significantly positive correlation with serum OPG, RANKL, and the differences were statistically significant(P<0.01).Conclusions The levels of OPG and RANKL in non dialysis CKD-MBD patients with kidney deficiency damp heat syndrome were higher than those in healthy people, and the ratio of OPG/RANKL was lower than that in healthy people; Rong Huang tonify kidney detoxification granules can achieve the purpose of preventing CKD-MBD by improve the clinical symptoms and renal function, increase serum Ca level,and reduce serum P, iPTH, ALP level of non dialysis CKD-MBD patients with kidney deficiency damp heat syndrome.The mechanism may be related to the elevation of serum OPG and the decrease of serum RANKL level and the increase of the ratio of OPG/RANKL.