Clinical Observation Of Treating Large Proteinuria In Chronic Renal Failure With Glucoside Tripterygium Total

Objective:To evaluate the clinical effect and safety of treating large proteinuria in Chronic Renal Failure with Glucoside Tripterygium Total.Methods:Clinical informations were gathered from patients with large proteinuria in Chronic Renal Failure who received treatment from March2008to March2012by the Nephrology Department in the Jiangsu Prvince Hospital of TCM and meet the standards of inclusive criteria and did’t meet the standards of exclusion criteria.The observation period last for one year. Compared the differences of the levels of BUN、SCr、eGFR、24h-UTP、ALT、AST、WBC in different observation(0month、one month、three month、six month、twelve month) between different Chronic renal failure periods before and after the treatment. Then analyzed these datas.Results:1、There were8patients whose renal function had been improved obviously,7had been improved,26had stable effect, and32had no effect after treatment, the total effective rate was56.2%.2、After treatment, the level of BUN of patients in CKD2phase and CKD4phase had no significant change (P>0.05), and they had little changed during the treatment (P>0.05), while the others were not. The one of patients in CKD3phase and CKD5phase had raised a lot after treatment, the difference was statistically significant (P<0.05). During the treatment, the level of BUN of patients in CKD3phase had raised apparently at the six month after treatment (P <0.05); the one of patients in CKD5phase had raised obviously since the treatment (P<0.05), but the increasing became slowly at three month after the treatment (P>0.05)3、The levels of SCr of patients in different CKD phases had no significant change before and after treatment (P>0.05). During the treatment, the levels of SCr of patients in CKD2phase and CKD4phase had no significant change (P>0.05), while the others were not. The level of patients in CKD3phase had a downtrend after treatment, but it raised significantly at three month aftertreatment (P<0.05). The one of patients in CKD5phase had apparently raised at six month after treatment.4、After treatment, the level of eGFR of patients in different CKD phases had no significant change (P>0.05), and it had no significant change during the treatment (P>0.05). 5、After treatment, the level of24h-UTP of patients in different phases had decreased, and the ones of patients in CKD3-4phases had more obvious reduction (P<0.05). During the treatment, the level of24h-UTP of patients in CKD3phase had a declining trend, the difference was statistically significant (P<0.05); while the others were not (P>0.05)6、9patients had clinical adverse experiences during the treatment, the rate was12.33%. Gastrointestinal symptoms occured more, the rate was8.22%,2women had menstrual disorder, the rate was9.52%.7、There were few patients whose transaminase levels were two times higher than the upper limit or the levels of WBC were lower than3×10^9/L. Few patients had severe liver injury and infection. The levels of transaminase and WBC went back to normal after treatment. There was no one whose renal function was injuried by glucoside tripterygium total.Conclusion:1、It’s effective to treat patients with large proteinuria in Chronic Renal Failure with glucoside tripterygium total based on the theray of the basic treatment of Western medicine and Chinese traditional treatment. Glucoside tripterygium total will reduce the level of proteinuria and then the renal function is improved.2、It’s safe to treat patients with large proteinuria in Chronic Renal Failure with glucoside tripterygium total. It can be taken for a long time.Liver function tests, routine analysis of blood and menstruation need be monitored regularly during the treatment.