The Clinical Study With Chronic Aristolochic Acid Nephropathy

Chronic Aristolochic Acid Nephropathy (CAAN) is a unique typeof nephropathy has been associated with the intake Chinese herbcontaining Aristolochic Acid (AA). The disease is characterized by thedevelopment of extensive renal interstitial fibrosis,tubular proteinuriaand with end-stage renal failure (ESRF). It reported that all CAANpatients had ingested the plant ingredient AA, the major alkaliod ofAristolochia species. The nephrotoxicity of Aristolochia species hasbeen traced to the plant alkaloid Aristolochic Acid (AA). Mammalianmodels were able to detect DNA adducts formed by AA metabolites.More, an association between the use of AA and urothelial cancer inCAAN patients has been reportd indicating that AA the major alkaloidof might be the causal agent. The proximal tubules is a target of thenephrotoxic process. A typical histological feature of CAAN is aprogressive interstitial fibrosis leading to a severe artophy of theproximal tubules. The destructive process reflect a severe decrease ofthe proximal tubules population and dysfunction, remaining intact theglomerular at least in the beginning of the disease. The patients withCAAN often present severe anemia and Fanconi syndrome such asaminoaciduria, tubular proteinuria, occult hematuria, renal diabetesand so on. Chronic Aristolochic Acid Nephropathy (CAAN) is regarded as akind of toxic nephropathy caused by the formation of aristolochic acidand DNA-aristolochic acid adducts in renal parenchymal cells.However, the underlying mechanisms driving the progression of renalinterstitial fibrosis in CAAN still remains unclear. There is littleclinical observation about the diagnosis and effective therapy withCAAN. In this article reteospective study will be done on 53cases inorder to further nvestigate clinical characteristics, therapeutic efficacyand prognosis of patients with with chronic aristolochic acidnephropathy (CAAN). Method: Chronic renal insufficiency caused byCAAN was diagnosed in 53 patients after intermittently taking themedicine containing aristolochic acid (AA) for a long time (from 1 to20 years). 53 patients diagnosed as CAAN were divided into 2 groups:one therapyrequired HD treatment (renal replaecment therapy), the othertherapy didn't require HD treatment . The patients of HD group hassevere omplication such as acidosis,congestive heart failure and so on.Renal function was assessed using Scr and BUN. t test will be used toshow data. Result: The level of Scr and BUN in both groups weresignificantly lower than prior to therapy (P<0.05). Conclusion:Boththerapies can slow the progression of renal failure and decrease thelevel of Scr and BUN .