Effect Of Yishen Jiangzhuo Granules Combined With Western Medicine On IFGF23,cFGF23,klotho And Phosphate Levels In CKD Stage 3-4 Patients

ObjectiveBy determining the levels of serum iFGF23,cFGF23,Klotho,calcium(Ca)and phosphate(P)in patients with chronic kidney disease stage 3-4 of spleen-kidney qi deficiency before and after treatment with Yishen Jiangzhuo Granule combined with Western,to observe the effect of the treatment regimen on serum iFGF23,cFGF23,Klotho and phosphate levels,and to explore the efficacy and deficiency of this treatment.MethodsA total of 70 non-dialysis patients with CKD stage 3–4 were included in the study as case groups(3 cases were excluded,1 of which did not review the indicators on time,and 2 cases stopped using Chinese medicine).Thirty healthy volunteers served as controls.Serum levels of iFGF23,cFGF23 and Klotho were measured by double antibody sandwich enzyme-linked immunosorbent assay(ELISA).Serum Ca,P,creatinine(Cre)and urea nitrogen(BUN)levels were determined by automatic biochemical analyzer(BECKMAN-C800).And estimated glomerular filtration rate(eGFR)was estimated by CKD-EPI equations.Analyze data with appropriate statistical methods.Results(1)Compared with before treatment,the levels of eGFR and Kotho were increased(P<0.05),serum BUN,Cre,P levels were decreased(P<0.05),serum iFGF23,cFGF23,Ca levels were not significantly changed(P>0.05)after treatment.(2)Compared with the normal group,serum iFGF23 levels in patients with CKD stage3-4 were significantly increased(P<0.05),serum Kotho levels were decreased(P<0.05),and serum cFGF23 levels were not significantly changed(P>0.05).(3)Simple correlation showed: iFGF23 was positively correlated with serum cFGF23(r=0.409,P<0.05),P(r=0.252,P<0.05),Cre(r=0.342,P<0.01),BUN(r=0.467,P<0.01),and was negatively correlated with eGFR(r=-0.346,P<0.01),and was not correlated with serum calcium;cFGF23 was positively correlated with P(r=0.284,P<0.05),and was not correlated with eGFR,Cre,BUN,calcium;Klotho is not associated with serum iFGF23,cFGF23,phosphate,creatinine,BUN,eGFR,and calcium.(4)Multivariate stepwise linear regression analysis showed that both iFGF23 and eGFR were independently associated with serum phosphate levels,and iFGF23 has the greatest impact on blood phosphate levels.Conclusion(1)Yishen Jiangzhuo Granule combined with Western medicine basic treatment can improve renal function and reduce serum phosphate level.(2)Yishen Jiangzhuo Granule combined with Western medicine can increase Klotho level,but has little effect on serum iFGF23 and cFGF23 levels.New effective drugs and means to reduce serum iFGF23 and cFGF23 levels of patients with CKD still need to be explored.