| Objective This study explored the effect of oral drug Aixite(Medicinal charcoal)on the levels of IS in serum,urine and feces of patients with CKD and the improvement of related clinical indicators and clinical symptoms,and further explored the connection of serum IS level with related clinical symptoms and clinical indicators.Methods Patients with chronic kidney disease diagnosed in the Department of Nephrology,including inpatient and outpatient of Hebei University,from June 2019 to December 2019 are selected,these patients meet the CKD staging criteria(K / DOQI chronic kidney disease diagnosis and staging criteria in 2002),aged 18-70 years.These patients were randomly divided into observation group and control group.Both groups were given conventional treatment(including low-quality high-quality protein diet,correction of water-electrolyte acid-base imbalance,control of infection,control of blood sugar,blood pressure,lipid regulation,correction of anemia,Treatment of renal osteopathy,symptomatic supportive treatment,etc.).On the basis of this,the observation group applied 5 medicinal charcoal tablets(1.5g)3 times a day for 3 months.The clinical symptoms were scored and take the fasting venous blood of the patient in the morning and save the urine and faeces specimen at 0 weeks and 12 weeks.Biochemical indicators were measured with an automatic analyzer,and the blood,urine,and stool IS concentrations in patients were detected by high performance liquid chromatography-fluorescence method.The t-test and self-paired t-test statistical methods were used to compare the indoxyl sulfate levels in the blood,urine and stool,Indicators and improvement of clinical symptoms between the two groups of patients and the single group of patients at 0 and 12 weeks.Results(1)General information: 129 patients with chronic kidney disease were enrolled,aged 29-70 years,78 male patients(60.5%)and 51 female patients(39.5%).Serum creatinine is between 192-564?mol/L,the primary kidney disease is chronic glomerulonephritis in 41(32%),hypertensive nephropathy in 22(17%),diabetic nephropathy in 38(29.5%),nephrotic syndrome 20 people(15.5%),and 8 people(6%)had othercauses.There were 66 people in the observation group,13 people withdrew halfway(5 people due to constipation,8 people due to increased blood pressure),the remaining 53 people,63 in the control group,15 people withdrew halfway(all choose dialysis due to increased blood creatinine),and the remaining 48 people.There was no significant difference in baseline data between the two groups of patients(P> 0.05).(2)The indoxyl sulfate levels in the blood,urine and stool of two groups:The observation group: At week 0,the blood IS concentration was(10.83 ± 12.19)?g/ml,the urine IS concentration was(33.39 ± 29.24)?g/ml,and the faeces IS concentration was(0.14 ± 0.05)mg / mg feces.And at week 12,the blood IS concentration was(5.14 ± 6.00)?g / ml,urine IS concentration was(17.63± 20.39)?g / ml,and faeces IS concentration was(0.31 ± 0.16)mg /mg feces.The control group: At week 0,the blood IS concentration was(11.89± 15.77)?g /ml,the urine IS concentration was(33.22± 29.08)?g / ml,and the faeces IS concentration was(0.13 ± 0.07)mg / mg feces.And at week 12,blood IS concentration was(10.24± 2.09)?g / ml,urine IS concentration was(32.62 ± 28.84)?g /ml,and faeces IS concentration was(0.12 ± 0.09)mg / mg feces.The blood and urine IS concentrations in the observation group were lower than those before treatment,and the faeces IS concentrations were higher than before treatment,and the differences were statistically significant(P <0.05).The blood and urine IS concentrations in the observation group were lower than those in the control group,and the faeces IS concentrations were higher in the observation group than in the control group(P <0.05).(3)Correlation between IS levels and clinical biochemical indicators and clinical symptoms: Pearson or Spearman correlation analysis between IS and clinical biochemical indicators and clinical symptom scores found that:IS and serum creatinine(r=0.800,P<0.01),urea nitrogen(r=0.591,P=0.026),cystatin C(r=0.907,P<0.01),?2-MG(r=0.914,P< 0.01),phosphorus(r= 0.765,P<0.01),and parathyroid hormone(r=0.618,P<0.01)are positively correlated;IS and glomerular filtration rate(eGFR)(r=-0.742,P<0.01),hemoglobin(r=-0.738,P<0.01),uric acid(r=-0.535,P=0.033),total cholesterol(r=-0.242,P<0.01),triglyceride(r=-0.147,p=0.02),low-density lipoprotein(r=-0.196,P<0.01),high-density lipoprotein(r=-0.248,P<0.01)are negatively correlated;There was no correlation between IS and albumin(r=-0.053,P=0.845)and blood calcium(r=-0.406,P=0.537);IS and itching of the skin(r=0.734,P<0.01),dryness of the skin(r=0.516,P<0.01),clinical symptoms(including appetite,nausea,vomiting,fatigue)(r=0.843,P< 0.01)was positively correlated.(4)Comparison of clinical biochemical indicators and clinical symptoms between the two groups of patients: There was a statistically significant difference between the observation group and the control group in serum creatinine,urea nitrogen,uric acid,blood phosphorus,PTH,skin itching and skin dryness,and clinical symptom score at 12 weeks of treatment,P<0.05.Conclusion: 1.Aixite reduces the concentration of IS in the blood by increasing the clearance of IS in the intestine.2.Aixite can reduce blood creatinine,urea nitrogen,and uric acid in patients with chronic kidney disease,and can improve clinical symptoms such as nausea,vomiting,fatigue,and skin itching.3.Aixite may reduce the level of parathyroid hormone by reducing the blood IS concentration,and improve the hyperparathyroidism. |
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