| Background and ObjectiveProtein malnutrition (PM) is a common finding in patients with chronic renal failure (CRF). Prevalence up to 65% has been reported in patients with end-stage renal disease (ESRD). Considerable evidence has accumulated over the last decade suggesting that malnutrition in uremic patients is associated with poor outcome. Malnutrition is known to be highly associated with morbidity and mortality in dialysis patients. PM and hypoalbuminemia are independent prediction of mortality. The pathogenesis of PM in CRF is multifactorial. Theoretically, PM may result from (1) inadequate dietary protein intake, (2) impaired small intestinal protein assimilation (digestion and absorption). (3) Increased protein losses, and/or (4) alterations in protein metabolism. To date, most researchers have focused on the impact of disturbances of metabolism. Resistance to protein anabolic hormones, especially resistance to insulin and insulin-like growth factor-I (IGF- I ); these hormones inhibit loss of muscle protein and stimulate protein synthesis. Metabolic acidosis, a frequent complication of uremia, has been shown to induce net protein catabolism by several mechanisms, Finally, High circulating levels of inflammatory cytokines, as seen in CRF patients, have been demonstrated to stimulate muscle protein breakdown. Prevention and treatment of malnutrition in CRF patients is a major issue. However, a clear method of treating this complication is still lacking. Further large-scale trials are needed to verify the usefulness and safety.The aim of the present study was to investigate the therapeutic effect of capsule of shenshuaiyangzhen(ssyz) on PM in CRF rats and explore its mechanism.Methods100 male SD rats were randomly divided into Normal group (N group,n=10) and the group for nephrectomy.Other 90 male SD rats weremade into CRF model by 5/6 nephrectomy . after 6 weeks the rats were identified to be CRF-PM model when their blood urea nitrogen(BUN),serum creatinine(Scr),serum albumin(ALB),and body weight lever reached to PM.Then all the CRF-PM model rats were randomly sorted into following groups: CRF group (C group) , high ssyz group(H group), Moderate ssyz group(M group), Low ssyz group(L group) and Western medicine control-Ketosteril group(K group).We measured food intake(g /day) and body weight(g) during the experiment. After treatment for four weeks. Nutritional indices such as ALB(g/dl), transferrin(TF, mg/dl), and insulin-like growth factor-1 (IGF-1, ng/ml) were measured to evaluate the PM, and nitrogen balance(NB) were detected to evaluate the protein metabolism.and protein amount of 24 hours urine(24hrUprV) were also measured. Simultaneously, ALBmRNA and IGF- I mRNA level were measured by RT-PCR in liver of rats.Results1 .After treatment,the levels of food intake and body weight in M groups were significantly higher than that in C group and K group.2.After treatment,the levers of serum ALB IGF-1 in treated groups were significantly higher than that in C group.serum IGF-1 concentrations in M group L group and K group elevate significantly than those before treatment.3. After treatment, the levers of NB in M group L group and K group improver than pre-treatment. There was no difference between these three groups.4.After treatment,The difference of 24hrUprV between pre-treatment and post-treatment in C group and K group were higher than those in M group and L group (x2=11.365,v=5,P=0.045) .5.Liver IGF-1 mRNA levers in H group M group and L group were higher than those in C group and K. group ( P<0.01) .6. Liver ALBmRNA levers in H group M group and L group were higher than those in C group and K group (P<0.01) . A significant linear positive correlation between the seum ALB and liver ALBmRNA levels were found.7. There were less TG, more HDL-C and LPLmRNA in M group than those in other treatment groups.ConclusionsResults of the present study provide some evidence that capsule of shenshuaiyangzhen can improve the level of Alb and IGF-1 in CRF rats by enhancing IGF-1 gene expre...
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