A Chinese patent medicine's long-term efficacy on non-dialysis patients with CKD stages 3-5: a retrospective cohort study

Hui-Fen Chen; Yu-Jie Lin; Yan Han; Xian-Long Zhang; Ruo-Bing Wang; Jun-Hui Chen; Ying Pi; Li-Zhe Fu; Fang Tang; Xi-Na Jie; Xiao-Na Tang; Xu-Sheng Liu; Yi-Fan Wu

doi:10.3389/fphar.2024.1379338

A Chinese patent medicine's long-term efficacy on non-dialysis patients with CKD stages 3-5: a retrospective cohort study

Front Pharmacol. 2024 Apr 26:15:1379338. doi: 10.3389/fphar.2024.1379338. eCollection 2024.

Authors

Hui-Fen Chen¹, Yu-Jie Lin¹, Yan Han¹, Xian-Long Zhang^{1

2}, Ruo-Bing Wang¹, Jun-Hui Chen¹, Ying Pi³, Li-Zhe Fu^{1

4}, Fang Tang^{1

4}, Xi-Na Jie^{1

2}, Xiao-Na Tang³, Xu-Sheng Liu^{1

2}, Yi-Fan Wu^{1

2}

Affiliations

¹ The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
² Renal Division, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China.
³ Bao'an Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, China.
⁴ Chronic Disease Management Outpatient Clinic, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, China.

Abstract

Background: Chinese patent medicine is commonly used in China as an important treatment mechanism to thwart the progression of chronic kidney disease (CKD) stages 3-5, among which Niaoduqing granules are a representative Chinese patent medicine; however, its long-term efficacy on CKD prognosis remains unclear.

Methods: Patients were grouped according to Niaoduqing granule prescription duration (non-Niaoduqing granule (non-NDQ) group vs Niaoduqing granule (NDQ) group). Serum creatinine (SCr) variation was compared using a generalized linear mixed model (GLMM). Multivariate Cox regression models were constructed, adjusting for confounding factors, to explore the risk of composite outcomes (receiving renal replacement therapy (RRT) or having an estimated glomerular filtration rate (eGFR)<5 mL/min/1.73 m², ≥50% decline in the eGFR from the baseline, and doubling of SCr) in individuals consuming Niaoduqing granules.

Results: A total of 1,271 patients were included, with a median follow-up duration of 29.71 (12.10, 56.07) months. The mean SCr Z-scores for the non-NDQ group and NDQ group were -0.175 and 0.153, respectively, at baseline (p = 0.015). The coefficients of the NDQ group from visit 1 to visit 5 were -0.207 (95% CI: -0.346, -0.068, p = 0.004), -0.214 (95% CI: 0.389, -0.039, p = 0.017), -0.324 (95% CI: 0.538, -0.109, p = 0.003), -0.502 (95% CI: 0.761, -0.243, p = 0.000), and -0.252 (95% CI: 0.569, 0.065, p = 0.119), respectively. The survival probability was significantly higher in the NDQ group (p = 0.0039). Taking Niaoduqing granules was a significant protective factor for thwarting disease progression (model 1: HR 0.654 (95% CI 0.489-0.875, p = 0.004); model 2: HR 0.646 (95% CI 0.476, 0.877, p = 0.005); and model 3: HR 0.602 (95% CI 0.442, 0.820, p = 0.001)).

Conclusion: The long-term use of Niaoduqing granules improved SCr variation and lowered the risk of CKD progression by 39.8%.

Keywords: Chinese patent medicine; Niaoduqing granules; chronic kidney disease; long-term efficacy; longitudinal analyze.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was supported by the National Key Research and Development Program of China (project no. 2019YFE0196300), the Guangzhou Technology Program of Agriculture and Social Development of Key Research and Development Scheme (project no. 202206010102), and the Sanming Project of Medicine in Shenzhen (no. SZZYSM202206014).