Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2021; 9(34): 10464-10471
Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10464
Effect of Nephritis Rehabilitation Tablets combined with tacrolimus in treatment of idiopathic membranous nephropathy
Wei Lv, Mei-Rong Wang, Cheng-Zhen Zhang, Xue-Xu Sun, Zhen-Zhen Yan, Xiao-Min Hu, Tao-Tao Wang
Wei Lv, Cheng-Zhen Zhang, Xue-Xu Sun, Tao-Tao Wang, Department of Nephology, China People’s Liberation Army 32298, Weifang 261000, Shandong Province, China
Mei-Rong Wang, Department of Pharmacy, China People’s Liberation Army 32298, Weifang 261000, Shandong Province, China
Zhen-Zhen Yan, Xiao-Min Hu, Department of Blood Purification, China People’s Liberation Army 32298, Weifang 261000, Shandong Province, China
Author contributions: Lv W, Wang MR, and Wang TT designed this study; Lv W, Wang MR, and Zhang CZ wrote this paper; Lv W, Wang MR, Zhang CZ, Sun XX, Yan ZZ, and Hu XM were responsible for sorting the data.
Institutional review board statement: The study was reviewed and approved by the Hospital of No. 80 Group Army Institutional Review Board (Approval No. 63).
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The manuscript was checked and revised according to the STROBE Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tao-Tao Wang, BMed, Attending Doctor, Department of Nephology, China People’s Liberation Army 32298, No. 256 North Palace West Street, Weicheng District, Weifang 261000, Shandong Province, China. 187254754@qq.com
Received: July 19, 2021
Peer-review started: July 19, 2021
First decision: August 19, 2021
Revised: August 22, 2021
Accepted: October 12, 2021
Article in press: October 12, 2021
Published online: December 6, 2021
Abstract
BACKGROUND

Idiopathic membranous nephropathy (IMN) has a high incidence in the middle-aged and elderly population, and poses a great threat to the physical and mental health and quality of life of patients. Nephritis Rehabilitation Tablets have many potential effects, such as clearing residual toxins, tumefying the kidney and spleen, replenishing qi, and nourishing yin, and have played an important role in the treatment of a variety of kidney diseases.

AIM

To investigate the efficacy and safety of Nephritis Rehabilitation Tablets combined with tacrolimus in the treatment of IMN.

METHODS

Eighty-four patients with IMN recruited from January 2017 to September 2020 were randomly divided into a study group (n = 42) and a control group (n = 42). On the basis of routine symptomatic treatment, both groups were treated with tacrolimus, and the study group was additionally treated with Nephritis Rehabilitation Tablets. Both groups were treated for 12 wk. The therapeutic effect, the levels of renal function indexes [serum creatinine (Scr), serum albumin, and 24-h urinary protein], urinary immunoglobulin (IgG4), membrane attack complex (C5b-9), and the incidence of adverse reactions were measured before and after 12 wk of treatment.

RESULTS

The total effective rate in the study group was significantly higher than that of the control group. Before treatment, there was no significant difference in Scr, serum albumin, or 24 h urinary protein between the two groups. After 12 wk of treatment, the levels of Scr and 24-h urinary protein in both groups were significantly lower and serum albumin was significantly higher than those before treatment (P < 0.05), and the levels of Scr and 24-h urinary protein were significantly lower (P = 0.003 and 0.000, respectively), and the level of serum albumin was significantly higher (P = 0.00) in the study group than in the control group. Before treatment, there was no significant difference in urinary IgG4 and C5b-9 levels between the study group and the control group (P = 0.336 and 0.438, respectively). After 12 wk of treatment, the levels of urinary IgG4 and C5b-9 in the two groups were lower than those before treatment, and the levels of urinary IgG4 and C5b-9 in the study group were significantly lower than those in the control group (P = 0.000). There was no significant difference in the incidence of adverse reactions between the two groups (P = 0.710).

CONCLUSION

Based on routine intervention, Nephritis Rehabilitation Tablets combined with tacrolimus in the treatment of IMN can effectively improve the renal function of patients and downregulate the expression of urinary IgG4 and C5b-9. In addition, they can improve the overall therapeutic effect while not increasing the risk of adverse reactions.

Keywords: Nephritis Rehabilitation Tablets, Tacrolimus, Idiopathic membranous nephropathy, Renal function, IgG4, C5b-9

Core Tip: Generally, Nephritis Rehabilitation Tablets combined with tacrolimus in the treatment of idiopathic membranous nephropathy can effectively improve the renal function of patients and downregulate the expression of urinary IgG4 and C5b-9. In addition, they can help to improve the overall treatment effect while not increasing the risk of adverse reactions.