Primary and secondary glomerulonephritis I

Le résumé fourni par la source

Introduction and Aims: Resistive index (RI) in renal Doppler ultrasonography (US) reflects renal vascular resistance. High RI is a risk factor for the progression of Chronic Kidney Disease (CKD). Moxibustion is a local thermal therapy and a part of traditional East Asian medical therapy that involves the burning of herbal preparations at the acupuncture points. It has been used for various conditions including hypertension, but not cleared the effect for renal disease. We investigated that moxibustion to the low back of healthy volunteers reduced RI of renal segmental arteries. The aim of our study was to evaluate the changes of renal hemodynamics by moxibustion in CKD patients. Methods: We enrolled 43 CKD patients without renal artery stenosis (age43.6±14.8 years old; 20 male, 23 female; CKD grade1 8, grade2 21, grade3 13, grade4 1; IgA nephritis 18, primary glomerular disease 14, Nephritis of Henoch-Schonlein purpura 4, Lupus nephritis 3, others 4; Blood pressure(BP) 121.4±15.6/76.9±12.3). We randomly assigned these patients two groups; first group was examined renal Doppler US at rest in the prone position, immediately after and 10 minutes after moxibustion, second group was same as above without moxibustion. Next, we examined the two groups with cross-over intervention within a month. Blood flow parameters were measured at three segmental arteries of each kidney and calculated the average value of bilateral kidney. BP, heart rate (HR) and body temperature (BT) were also measured at the same time. Indirect-moxibustion treatment was applied three times of 4 minutes stimulation at bilateral low back acupuncture points (BL-23) in related to renal function according to traditional medical theory. Moxibustion was administered by a nephrologist and Doppler US examiner was another nephrologist who was blinded if the patient was under intervention or not. Main outcome measurement was mean RI of six renal segmental arteries. Results: Mean RI value were significantly reduced at immediately after (P<0.01) and 10 minutes after moxibustion (P<0.01) from baseline value. In the treatment trial, the RI value at baseline, immediately after and 10 minutes after moxibustion were 0.603±0.06, 0.581±0.066, and 0.578±0.061, respectively, whereas those of the control trial were 0.601±0.054, 0.597±0.057, and 0.597±0.057 respectively. No significant changes were observed in the control trial. A significant differences in RI value were also observed between the treatment and control trials immediate after (P<0.05) and 10 minutes after intervention (P<0.01). Systolic BP and HR were reduced in each groups but no significant difference inter groups. There were no adverse events. Conclusions: These results indicate that thermal stimulation using moxibustion reduced RI of renal segmental arteries in CKD patients. This thermal therapy might induce therapeutic effect to prevent CKD progression with improving renal blood flow.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.