Clinical study of total glucosides of paeony for the treatment of diabetic kidney disease in patients with diabetes mellitus

Int Urol Nephrol. 2016 Nov;48(11):1873-1880. doi: 10.1007/s11255-016-1345-5. Epub 2016 Jun 24.

Abstract

Background and aim: Total glucosides of paeony (TGP), an active compound extracted from dried roots of Paeonia lactiflora Pall, have anti-inflammatory effects. This study investigated the efficacy and safety of TGP for treating diabetic kidney disease (DKD) in type 2 diabetes mellitus patients.

Methods: An open-label, prospective, randomized, parallel-group, single-site study involving 76 patients with DKD. Patients were randomized into two groups: losartan group (n = 38), treated with losartan 100 mg/day for 6 months and TGP group (n = 38), treated with TGP 1800 mg/day and losartan 100 mg/day for 6 months. Serum hs-CRP, MCP-1, and TNF-α were determined before and after treatment. Urinary albumin excretion rate (UAER), fasting blood glucose, serum creatinine, and lipid profiles were examined.

Results: At the end-point, UAER decreased in the TGP group compared with baseline. UAER in the losartan group decreased to a level lower than before treatment. The rate of decline in the losartan group was significantly lower than the TGP group. There were no significant differences in serum creatinine and albumin levels between TGP and losartan groups at the end-point. Serum hs-CRP, MCP-1, and TNF-α levels were significantly lower in both groups after treatment. After treatment, serum hs-CRP, MCP-1, and TNF-α in the TGP group decreased more than the losartan group. Positive correlations were observed between UAER and hs-CRP, MCP-1, and TNF-α. No statistically significant difference in side effects was observed between groups.

Conclusion: Our study showed that TGP treatment could reduce the albuminuria and inflammatory markers in type 2 diabetes mellitus patients with DKD.

Keywords: Albumin excretion rate; Diabetic kidney disease; Inflammation; Total glucosides of paeony.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Albuminuria / urine
  • Antihypertensive Agents / therapeutic use
  • Blood Glucose / metabolism
  • C-Reactive Protein / metabolism
  • Chemokine CCL2 / blood
  • Creatinine / blood
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetic Nephropathies / blood
  • Diabetic Nephropathies / drug therapy*
  • Diabetic Nephropathies / etiology
  • Drug Therapy, Combination
  • Female
  • Glucosides / adverse effects
  • Glucosides / therapeutic use*
  • Humans
  • Losartan / therapeutic use
  • Male
  • Middle Aged
  • Paeonia*
  • Phytotherapy*
  • Plant Extracts / adverse effects
  • Plant Extracts / therapeutic use*
  • Plant Roots
  • Prospective Studies
  • Serum Albumin / metabolism
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Antihypertensive Agents
  • Blood Glucose
  • CCL2 protein, human
  • Chemokine CCL2
  • Glucosides
  • Plant Extracts
  • Serum Albumin
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein
  • Creatinine
  • Losartan