Herbal Science Research - urinary

[Advances in studies on pharmacokinetics of aristolochic acid I]

Site Editor — Fri, 02 Nov 2007 15:29:34 -0700

[Advances in studies on pharmacokinetics of aristolochic acid I]: Zhongguo Zhong Yao Za Zhi. 2006 Oct;31(19):1573-5 Authors: Wang G, Wang ZM, Sun QS

Aristolochic acid I (AA-I) was absorbed and distributed quickly in vivo, the plasma concentration-time curve were fit with the open two-compartment model and one-compartment model, respectively. The elimination of AA-I has relationship with the dosage, the low dose group eliminates more quickly than the high dose group. The characters of pharmacokinetics of AA-I induce the cumulation of AA-I in vivo and the nephrotoxin to the kidney and other viscera.

PMID: 17165576 [PubMed - indexed for MEDLINE]

Dose-response effect of Red Maca (Lepidium meyenii) on benign prostatic hyperplasia induced by testosterone enanthate.

Site Editor — Wed, 26 Sep 2007 18:51:16 -0700

Dose-response effect of Red Maca (Lepidium meyenii) on benign prostatic hyperplasia induced by testosterone enanthate.: Phytomedicine. 2007 Aug;14(7-8):460-4 Authors: Gasco M, Villegas L, Yucra S, Rubio J, Gonzales GF

The main goal of this study was to determine the effect of a freeze-dried aqueous extract of the red variety of Lepidium meyenii (Red Maca) on testosterone-induced benign prostatic hyperplasia (BPH) in adult rats of the Holtzman strain. Rats were treated with freeze-dried aqueous extract of Red Maca at doses of 0, 0.01, 0.05, 0.1, and 0.5 g/kg body wt. A positive control group received Finasteride (0.6 mg/kg body wt.). After treatment, the animals were sacrificed, and the ventral prostate was extracted, and weighed. HPLC was used to determine the presence of glucosinolates in Red Maca. The prostate weight diminished in a dose-dependent fashion in rats treated with Red Maca. The effect of Red Maca was better than that observed with Finasteride. Finasteride, but not Red Maca, reduced seminal vesicles weight. Analysis of the HPLC indicated the presence of benzyl glucosinolate (Glucotropaeolin) with a content of 0.639%. Serum testosterone levels were not affected by Red Maca. Moreover, serum testosterone levels were not related to prostate or seminal vesicles weight in rats treated with vehicle and Red Maca. In conclusion, Red Maca administered orally in rats seems to exert an inhibitory effect at a level post DHT conversion, on the BPH-induced experimentally, although a direct measure of reductase action would still be required.

PMID: 17289361 [PubMed - indexed for MEDLINE]

[Prevention and alternative methods for prophylaxis of recurrent urinary tract infections in women]

Site Editor — Mon, 11 Jun 2007 06:43:56 -0700

[Prevention and alternative methods for prophylaxis of recurrent urinary tract infections in women]: Urologe A. 2006 Apr;45(4):443-4, 446-50 Authors: Vahlensieck W, Bauer H

General recommendations to prevent recurrent urinary tract infections (rUTI) result in about one-third of patients remaining free of recurrences. Oral and parenteral immunotherapy were effective in several controlled studies for prevention of rUTI. These therapies can be combined with acute antibiotic therapy. Vaginal prophylaxis with oestriol has proven its positive effect without serious gynaecological side effects. Also there is increasing evidence that cranberries prevent rUTI. The exact mode (juice, tablets or preserved berries), dosage and duration of this therapy remain to be defined. There are also promising therapy modalities such as changing bacterial gut flora, general immune response (acupuncture, inpatient rehabilitation) and urine acidity.

Antioxidant capacity of 55 medicinal herbs traditionally used to treat the urinary system: a comparison...

Site Editor — Wed, 21 Feb 2007 17:59:06 -0800

Antioxidant capacity of 55 medicinal herbs traditionally used to treat the urinary system: a comparison using a sequential three-solvent extraction process.: J Altern Complement Med. 2007 Jan;13(1):103-10 Authors: Wojcikowski K, Stevenson L, Leach D, Wohlmuth H, Gobe G

Background: The prevalence of chronic renal disease exceeds 10% in industrialized societies. Oxidative damage is thought to be one of the main mechanisms involved in nearly all chronic renal pathologies. Objective: We aimed to use the oxygen radical absorbance capacity (ORAC) method and a sequential multisolvent extraction process to compare the in vitro antioxidant capacity of 55 medicinal herbs and prioritize them for in vivo studies investigating the value of herbal therapies in the treatment of renal disorders. Methods: The herbs were chosen on the basis of their traditional use in kidney or urinary system disorders, or because they have attracted the attention of recent investigations into renal pathologies. The three solvents used for extraction were ethyl acetate, methanol, and 50% aqueous methanol. Silybum marianum (milk thistle) seed and Camellia sinensis (tea) leaf, both known to possess high antioxidant capacity, were included for comparison. Results: Twelve of the 55 herbs were comparable to or exceeded ORAC levels of milk thistle seed or tea leaf. The highest radical-scavenging activity was found in Olea europaea (olive leaf), Cimicifuga racemosa (black cohosh), Rheum palmatum (rhubarb), Glycyrrhiza glabra (licorice), and Scutellaria lateriflora (Virginia skullcap). Conclusions: The antioxidant capacity of many of the herbs studied may, at least in part, be responsible for their reputation as being protective of organs of the urinary system. Overall, the combined ORAC values for the methanol and aqueous methanol extracts comprised 84% of the total ORAC value. Sequential extraction with solvents of different polarities may be necessary to fully extract the antioxidant principles from medicinal plants.

Medicinal plants used in Kirklareli Province (Turkey).

Site Editor — Wed, 31 Jan 2007 19:04:35 -0800

Medicinal plants used in Kirklareli Province (Turkey).: J Ethnopharmacol. 2006 Dec 12; Authors: Kültür S

In this paper, 126 traditional medicinal plants from Kirklareli Province in Turkey have been reported. One hundred and twenty six plant species belonging to 54 families and among them 100 species were wild and 26 species were cultivated plants. Most used families were Rosaceae, Labiatae, Compositae and the most used plants were Cotinus coggyria, Sambucus ebulus, Achillea millefolium subsp. pannonica, Hypericum perforatum, Matricaria chamomilla var. recutita, Melissa officinalis subsp. officinalis, Juglans regia, Thymus longicaulis subsp. longicaulis var. subisophyllus, Malva sylvestris, Urtica dioica, Plantago lanceolata, Rosa canina, Ecballium elaterium, Artemisia absinthium, Viscum album subsp. album, Papaver rhoeas, Helleborus orientalis, Cydonia oblonga, Prunus spinosa subsp. dasyphylla, Rubus discolor, Sorbus domestica. A total of 143 medicinal uses were obtained. The traditional medicinal plants have been mostly used for the treatment of wounds (25.3%), cold and influenza (24.6%), stomach (20%), cough (19%), kidney ailments (18.2%), diabetes (13.4%).

Pygeum africanum extract inhibits proliferation of human cultured prostatic fibroblasts and myofibroblasts.

Site Editor — Sat, 20 Jan 2007 00:18:55 -0800

Pygeum africanum extract inhibits proliferation of human cultured prostatic fibroblasts and myofibroblasts.: >BJU Int. 2006 Nov;98(5):1106-13 Authors: Boulbès D, Soustelle L, Costa P, Haddoum M, Bali JP, Hollande F, Magous R

OBJECTIVE: To investigate the effect of Pygeum africanum (PA) extract on the proliferation of cultured human prostatic myofibroblasts and fibroblasts; this extract is used for treating urinary disorders associated with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: Primary cultures of prostatic stromal cells were obtained from histologically confirmed human BPH by enzymatic digestion. Cell proliferation was measured by 5-bromo2'-deoxy-uridine (BrdU) incorporation assays, and cytotoxicity by luminescent quantification of adenylate kinase activity. RESULTS: Cultured cells were labelled by an anti-vimentin antibody, and most of them by an alpha-smooth-muscle-actin antibody, revealing the presence of fibroblasts and myofibroblasts. BrdU incorporation tests showed that proliferation of cultured human stromal cells, stimulated by fetal calf serum, by basic fibroblast growth factor and by epidermal growth factor, was dose-dependently inhibited by PA extract (5-100 microg/mL). Except at 100 microg/mL, no acute cytotoxicity of the extract was detected after 24 h of culture. Similarly, the extract dose-dependently inhibited the proliferation of Madin-Darby canine kidney epithelial cells, but to a lesser extent; whatever the dose of extract, no acute toxicity was evident on this cell line. CONCLUSION: PA extract inhibits the proliferation of cultured human prostatic myofibroblasts and fibroblasts. We propose that cultured human prostatic cells offer a reliable model for preclinical screening of therapeutic agents, and to study the mechanisms underlying the inhibition of proliferation.

The effect of modified citrus pectin on urinary excretion of toxic elements.

Site Editor — Thu, 04 Jan 2007 17:43:47 -0800

The effect of modified citrus pectin on urinary excretion of toxic elements.: Phytother Res. 2006 Oct;20(10):859-64 Authors: Eliaz I, Hotchkiss AT, Fishman ML, Rode D

This study was undertaken to evaluate the effect of modified citrus pectin (MCP) on the urinary excretion of toxic elements in healthy individuals. MCP is a reduced molecular weight pectin (weight-average molar mass = 15,400) that is mostly linear homogalacturonan with a 3.8% degree of esterification and approximately 10% rhamnogalacturonan II based on the presence of 2-keto-3-deoxy-octonic acid. Subjects ingested 15 g of MCP (PectaSol, EcoNugenics Inc., Santa Rosa, California 95407) each day for 5 days and 20 g on day 6. Twenty-four hour urine samples were collected on day 1 and day 6 for comparison with baseline. The urine samples were analysed for toxic and essential elements. In the first 24 h of MCP administration the urinary excretion of arsenic increased significantly (130%, p < 0.05). On day 6, urinary excretion was increased significantly for cadmium (150%, p < 0.05). In addition, lead showed a dramatic increase in excretion (560%, p < 0.08). This pilot trial provides the first evidence that oral administration of MCP increases significantly the urinary excretion of toxic metals in subjects with a 'normal' body load of metals. It is suggested that systemic chelation of toxic metals by MCP may in part be attributable to the presence of rhamnogalacturonan II, which has been shown previously to chelate metals.

Hypericum perforatum L. extract - novel photosensitizer against human bladder cancer cells.

Site Editor — Thu, 05 Oct 2006 18:29:10 -0700

Hypericum perforatum L. extract - novel photosensitizer against human bladder cancer cells.: J Photochem Photobiol B. 2006 Jul 3;84(1):64-9 Authors: Stavropoulos NE, Kim A, Nseyo UU, Tsimaris I, Chung TD, Miller TA, Redlak M, Nseyo UO, Skalkos D

The polar methanolic fraction (PMF) of the Hypericum perforatum L. extract has recently been developed and tested as a novel, natural photosensitizer for use in the photodynamic therapy (PDT), and photodynamic diagnosis (PDD). PMF has been tested on HL-60 leukemic cells and cord blood hemopoietic progenitors. In the present study, the efficacy of PMF as a phototoxic agent against urinary bladder carcinoma has been studied using the T24 (high grade metastatic cancer), and RT4 (primary low grade papillary transitional cell carcinoma) human bladder cancer cells. Following cell culture incubation, PMF was excited using 630 nm laser light. The photosensitizer exhibited significant photocytotoxicity in both cell lines at a concentration of 60microg/ml, with 4-8 J/cm(2) light dose, resulting in cell destruction from 80% to 86%. At the concentration of 20microg/ml PMF was not active in either cell line. These results were compared with the results obtained in the same cell lines, under the same conditions with a clinically approved photosensitizer, Photofrin. Photofrin was used in the maximum clinically tolerable dose of 4microg/ml, and it was also excited with 630 nm laser light. In the T24 cell Photofrin exhibited slightly less photocytotocixity, compared with PMF, resulting in 77% cell death with 8J/cm(2) light dose. However, against the RT4 cells Photofrin resulted in minimal cell death (9%) with even 8J/cm(2) light dose. Finally, the type of cell death induced by PMF photoactivation was studied using flow cytometry and DNA laddering. Cell death by PMF photodynamic action in these two bladder cell lines is caused predominently by apoptosis. The reported significant photocytotoxicity, selective localization, natural abundance, easy, and inexpensive preparation, underscore that the PMF extract hold the promise of being a novel, effective PDT photosensitizer.

Saw palmetto for benign prostatic hyperplasia.

Site Editor — Fri, 09 Jun 2006 07:23:58 -0700

Saw palmetto for benign prostatic hyperplasia.: N Engl J Med. 2006 Feb 9;354(6):557-66 Authors: Bent S, Kane C, Shinohara K, Neuhaus J, Hudes ES, Goldberg H, Avins AL

BACKGROUND: Saw palmetto is used by over 2 million men in the United States for the treatment of benign prostatic hyperplasia and is commonly recommended as an alternative to drugs approved by the Food and Drug Administration. METHODS: In this double-blind trial, we randomly assigned 225 men over the age of 49 years who had moderate-to-severe symptoms of benign prostatic hyperplasia to one year of treatment with saw palmetto extract (160 mg twice a day) or placebo. The primary outcome measures were changes in the scores on the American Urological Association Symptom Index (AUASI) and the maximal urinary flow rate. Secondary outcome measures included changes in prostate size, residual urinary volume after voiding, quality of life, laboratory values, and the rate of reported adverse effects. RESULTS: There was no significant difference between the saw palmetto and placebo groups in the change in AUASI scores (mean difference, 0.04 point; 95 percent confidence interval, -0.93 to 1.01), maximal urinary flow rate (mean difference, 0.43 ml per minute; 95 percent confidence interval, -0.52 to 1.38), prostate size, residual volume after voiding, quality of life, or serum prostate-specific antigen levels during the one-year study. The incidence of side effects was similar in the two groups. CONCLUSIONS: In this study, saw palmetto did not improve symptoms or objective measures of benign prostatic hyperplasia. (ClinicalTrials.gov number, NCT00037154.).

Inhibition of Helicobacter pylori and associated urease by oregano and cranberry phytochemical synergies.

Site Editor — Fri, 09 Jun 2006 07:18:56 -0700

Inhibition of Helicobacter pylori and associated urease by oregano and cranberry phytochemical synergies.: Appl Environ Microbiol. 2005 Dec;71(12):8558-64

Authors: Lin YT, Kwon YI, Labbe RG, Shetty K

Ulcer-associated dyspepsia is caused by infection with Helicobacter pylori. H. pylori is linked to a majority of peptic ulcers. Antibiotic treatment does not always inhibit or kill H. pylori with potential for antibiotic resistance. The objective of this study was to determine the potential for using phenolic phytochemical extracts to inhibit H. pylori in a laboratory medium. Our approach involved the development of a specific phenolic profile with optimization of different ratios of extract mixtures from oregano and cranberry. Subsequently, antimicrobial activity and antimicrobial-linked urease inhibition ability were evaluated. The results indicated that the antimicrobial activity was greater in extract mixtures than in individual extracts of each species. The results also indicate that the synergistic contribution of oregano and cranberry phenolics may be more important for inhibition than any species-specific phenolic concentration. Further, based on plate assay, the likely mode of action may be through urease inhibition and disruption of energy production by inhibition of proline dehydrogenase at the plasma membrane.

Acute renal failure induced by a Brazilian variety of propolis.

Site Editor — Fri, 09 Jun 2006 07:15:57 -0700

Acute renal failure induced by a Brazilian variety of propolis.: Am J Kidney Dis. 2005 Dec;46(6):e125-9 Authors: Li YJ, Lin JL, Yang CW, Yu CC

Propolis is a resinous substance collected by honeybees and used in hive construction and maintenance. Cumulative evidence suggests that propolis may have anti-inflammatory, antibiotic, antioxidant, antihepatotoxic, and antitumor properties. In addition to topical applications, products containing propolis have been used increasingly as dietary supplements. Although reports of allergic reactions are not uncommon, propolis is reputed to be relatively nontoxic. Its systemic toxicity is rarely reported and hence may be underestimated. This is the first report of propolis-induced acute renal failure. A 59-year-old man required hemodialysis for acute renal failure. The patient had cholangiocarcinoma and had ingested propolis for 2 weeks before presentation. Renal function improved after propolis withdrawal, deteriorated again after reexposure, and then returned to a normal level after the second propolis withdrawal. This case indicates that propolis can induce acute renal failure and emphasizes the need for vigilance and care when propolis is used as a medicine or dietary supplement.

Beneficial effects of the bioflavonoids curcumin and quercetin on early function in cadaveric renal transplantation...

Site Editor — Fri, 09 Jun 2006 07:12:22 -0700

Beneficial effects of the bioflavonoids curcumin and quercetin on early function in cadaveric renal transplantation: a randomized placebo controlled trial.: Transplantation. 2005 Dec 15;80(11):1556-9 Authors: Shoskes D, Lapierre C, Cruz-Corerra M, Muruve N, Rosario R, Fromkin B, Braun M, Copley J

BACKGROUND: The bioflavonoids quercetin and curcumin are renoprotective natural antioxidants. We wished to examine their effects on early graft function (EF). METHODS: Between September 2002 and August 2004, 43 dialysis dependent cadaveric kidney recipients were enrolled into a study using Oxy-Q which contains 480 mg of curcumin and 20 mg of quercetin, started after surgery and taken for 1 month. They were randomized into three groups: control (placebo), low dose (one capsule, one placebo) and high dose (two capsules). Delayed graft function (DGF) was defined as first week dialysis need and slow function (SGF) as Cr >2.5 mg/dl by day 10. Category variables were compared by chi squared and continuous variables by Kruskal-Wallis. RESULTS: There were four withdrawals: one by patient choice and three for urine leak. The control group had 2/14 patients with DGF vs. none in either treatment group. Incidence of EF was control 43%, low dose 71% and high dose 93% (P=0.013). Serum creatinine was significantly lower at 2 days (control 7.6+/-2.1, low 5.4+/-0.6, high 3.96+/-.35 P=0.0001) and 30 days (control 1.82+/-.16, low 1.65+/-.09, high 1.33 +/-.1, P=0.03). Acute rejection incidence within 6 months was control 14.3%, low dose 14.3% and high dose 0%. Tremor was detected in 13% of high dose patients vs. 46% of others. Urinary HO-1 was higher in bioflavonoid groups. CONCLUSION: Bioflavonoid therapy improved early graft function. Acute rejection and neurotoxicity were lowest in the high dose group. These bioflavonoids improve early outcomes in cadaveric renal transplantation, possibly through HO-1 induction.

Adjuvant intravesical treatment with standardized mistletoe extract to prevent recurrence of superficial urinary bladder cancer

Site Editor — Fri, 09 Jun 2006 04:29:56 -0700

Adjuvant intravesical treatment with a standardized mistletoe extract to prevent recurrence of superficial urinary bladder cancer.: Anticancer Res. 2005 Nov-Dec;25(6C):4733-6 Authors: Elsässer-Beile U, Leiber C, Wetterauer U, Bühler P, Wolf P, Lucht M, Mengs U

BACKGROUND: Adjuvant intravesical Bacillus Calmette-Guerin (BCG) treatment after resection of non invasive superficial bladder cancer has been shown to significantly decrease tumor recurrence. However, the serious local and systemic side-effects of this treatment have promoted the use of other immunoactive substances, which, to date, have all failed to show efficacy equal to BCG therapy. PATIENTS AND METHODS: In the present phase I/II clinical trial, an aqueous mistletoe extract, standardized to mistletoe lectin, was applied intravesically to 30 patients with superficial urothelial bladder carcinomas of stages pTa and pT1, grades 1 to 2. After transurethral resection, each patient received 6 instillations at weekly intervals of 50 ml of the extract with mistletoe lectin concentrations between 10 ng/ml and 5000 ng/ml. This was retained in the bladder for 2 hours. Three patients per group received a dose, which was then doubled in the next group. The clinical follow-up consisted of examinations by cystoscopy, cytology and random biopsies. RESULTS: Within the observation time of 12 months, 9 patients had tumor recurrence, while 21 patients remained tumor-free. This recurrence rate was comparable to that of local historical controls with superficial bladder cancer of the same stages and grades that had been treated with adjuvant BCG. The tolerability of the intravesically-administered mistletoe extract was very good. None of the study patients had local or systemic side-effects according to the WHO classification 1-4. CONCLUSION: From these results, it is concluded that the standardized mistletoe extract could be a potential adjuvant therapy for superficial bladder cancer. Further studies may show the optimal intravesical treatment regimen.

[Clinical observation of Gingko biloba extract injection in treating early diabetic nephropathy.]

Site Editor — Fri, 09 Jun 2006 04:20:42 -0700

[Clinical observation of Gingko biloba extract injection in treating early diabetic nephropathy.]: Chin J Integr Med. 2005 Sep;11(3):226-8 Authors: Lu J, He H

OBJECTIVE: To observe the effect of Ginkgo biloba extract injection (GB) in treating early diabetic nephropathy (DN). METHODS: Sixty DN patients were divided into two groups, the treated group were treated by GB and Western medicine, and the control group were given Western medicine alone. The study lasted for 4 weeks. Fasting plasma glucose (FPG), blood pressure, 24 h urinary albumin excretion (UAE), endogenous creatinine clearance rate (Ccr), blood lipids and hemorheology indices were examined before and after the study. RESULTS: Compared with the control group, UAE were significantly decreased (P < 0.01); Ccr, blood lipids and hemorheology indices were all improved after treatment in the treated group (P < 0.05 or P < 0.01). But in FPG and blood pressure there was no significant change between the treated group and the control group (P > 0.05). CONCLUSION: GB is effective in treating early DN through decreasing urinary albumin excretion rate, regulating blood lipids, improving renal function and hemorheology.

Inhibition of uropathogenic Escherichia coli by cranberry juice: a new antiadherence assay.

Site Editor — Fri, 09 Jun 2006 04:05:29 -0700

Inhibition of uropathogenic Escherichia coli by cranberry juice: a new antiadherence assay.: J Agric Food Chem. 2005 Nov 16;53(23):8940-7 Authors: Turner A, Chen SN, Joike MK, Pendland SL, Pauli GF, Farnsworth NR

A combination of microplate technology and turbidity assessment for testing the adherence of P-fimbriated Escherichia coli to human uroepithelial cell line T24, validated with the addition of the known inhibitor 4-O-alpha-D-galactopyranosyl-alpha-D-galactopyranose (galabiose), resulted in a high-throughput, biologically relevant assessment of cranberry (Vaccinium macrocarpon). P-fimbriated ATCC E. coli strains 25922, 29194, and 49161 were inhibited by galabiose. ATCC 29194, a representative urine isolate containing the papGII allele (Class II fimbrial adhesin) and demonstrating the most significant inhibition in the presence of galabiose, was chosen for further testing. In this assay, a low-polarity fraction of cranberry juice cocktail demonstrated dose-dependent inhibition of E. coli adherence. Reported here, for the first time in V. macrocarpon, are 1-O-methylgalactose, prunin, and phlorizin, identified in an active fraction of cranberry juice concentrate. This in vitro assay will be useful for the standardization of cranberry dietary supplements and is currently being used for bioassay-guided fractionation of cranberry juice concentrate.

Protective effect of propolis ethanol extract on ethanol-induced renal toxicity: an in-vivo study.

Site Editor — Fri, 09 Jun 2006 03:59:04 -0700

Protective effect of propolis ethanol extract on ethanol-induced renal toxicity: an in-vivo study.: Am J Chin Med. 2005;33(5):779-86 Authors: Liu CF, Lin CH, Lin CC, Lin YH, Chen CF, Lin SC

Acute p.o. administration of absolute ethanol (10 ml/kg) to fasted mice would produce extensive renal failure. Pretreatment with p.o. administration of propolis ethanol extract (PEE) could prevent such renal failure effectively and dose dependently. This renal protective effect of PEE may be contributed, at least in part, to its antioxidative activity. The maximal antioxidative effect against absolute ethanol (AE)-induced renal failure could be observed 1 hour after PEE administration. In order to further investigate the renal protective mechanism of PEE, lipid peroxidation and superoxide scavenging activity were conducted in vivo. PEE exhibited dose-dependent antioxidative effects on lipid peroxidation in mice renal homogenate. Results indicated that mice with acute renal failure have higher malonic dialdehyde (MDA) levels compared with those in PEE administered mice. It was concluded that the renal protective mechanism of PEE could be contributed, at least in part, to its prominent superoxide scavenging effect; hence, it could protect, indirectly, the kidney from superoxide-induced renal damages.

Chinese herb nephropathy.

Site Editor — Fri, 09 Jun 2006 03:58:48 -0700

Chinese herb nephropathy.: Proc (Bayl Univ Med Cent). 2000 Oct;13(4):334-337 Authors: Meyer MM, Chen TP, Bennett WM

In 1994, a 44-year-old woman progressed from normal renal function to advanced renal failure and end-stage renal disease within 8 months. Biopsy revealed extensive interstitial fibrosis with focal lymphocytic infiltration. She received a cadaveric renal transplant in January 1996 and had an uneventful posttransplant course. As a result of a minor motor vehicle accident, the patient had received acupuncture and Chinese herbal medicine for pain relief approximately 5 months before the onset of renal symptoms. After the transplant, analysis of the herbal remedies clearly indicated the presence of aristolochic acid in 2 of the 6 Chinese herbs ingested. Ingestion of aristolochic acid has been linked to a newly defined entity, Chinese herb nephropathy (CHN). This article discusses the history of CHN and its implication in the current case and in other recent similar cases and makes recommendations to avoid future problems caused by unregulated use of herbal medicines. This is the first reported case of CHN in the USA.

Effects of herbal supplements on the kidney.

Site Editor — Fri, 09 Jun 2006 03:05:37 -0700

Effects of herbal supplements on the kidney. - Urol Nurs. 2005 Oct;25(5):381-6, 403 Authors: Combest W, Newton M, Combest A, Kosier JH

Complementary and alternative medicine in urology.

Site Editor — Fri, 09 Jun 2006 03:03:29 -0700

Complementary and alternative medicine in urology. - BJU Int. 2005 Dec;96(8):1177-84 Authors: Dreikorn K

Complementary and alternative medicine (CAM) includes various practices, measures and products which are not presently considered to be a part of conventional (mainstream) medicine. Herbal products, vitamins, minerals and amino acids are increasingly popular as dietary supplements for the treatment, improvement and prophylaxis of urological diseases, and to improve general health and well-being. As these products are freely available without prescription, conventional healthcare providers are often unaware that their patients are using CAM. It is essential to know that some herbal supplements may act in the same way as chemical drugs, and that they originate 'from nature' does not mean that they are safe and/or with no potential harmful effects and/or toxicity. Eventual interactions with conventional medications and contamination with prescription drugs and metals have been reported. The active components of many phytotherapeutic preparations and their mechanism(s) of action are still being determined and evaluated. There is scientific evidence for the effectiveness of some CAM treatments, but for most there are important key questions yet to be answered through basic research and well-designed studies according to established guidelines. Because of the increasing popularity and use of CAM, conventional healthcare providers, including urologists, should not ignore it, and be well informed about the benefits and potential risks of dietary supplements, so that they can advise their patients about this developing field. Whenever necessary and possible, lifestyle and behavioural changes should be recommended before using CAM, and eventually be supplemented by CAM as a second step.

Investigating the protective effects of aged garlic extract on cyclosporin-induced nephrotoxicity in rats.

Site Editor — Sun, 28 May 2006 22:47:54 -0700

Investigating the protective effects of aged garlic extract on cyclosporin-induced nephrotoxicity in rats.: Fundam Clin Pharmacol. 2005 Oct;19(5):555-62 Authors: Wongmekiat O, Thamprasert K

Cyclosporin A (CsA) nephrotoxicity has been described in solid organ recipients and in the patients who were treated for autoimmune diseases. Reactive oxygen species-induced oxidative stress and lipid peroxidations are implicated in the pathophysiology of CsA-induced renal injury. Aged garlic extract (AGE) has been reported to exhibit potent antioxidative and free radical scavenging abilities in various disease conditions. The present study was designed to investigate whether AGE could possibly have a protective effect against nephrotoxicity induced by CsA. Male Wistar rats were treated orally with CsA (50 mg/kg/day), CsA + AGE (0.25, 0.5, 1, and 2 g/kg/day started 3 days before the first dose of CsA), or the vehicle of CsA for a period of 10 days. Blood urea nitrogen, serum creatinine, creatinine clearance, and renal histopathological changes were evaluated after 24 h of the last treatment. CsA caused an increase in blood urea nitrogen and serum creatinine by 117 and 100%, respectively, whereas it decreased creatinine clearance by 78% compared with the vehicle-treated rats (all P < 0.001). AGE treatment (0.5, 1 and 2 g/kg) significantly protected animals against CsA-induced biochemical changes, albeit blood urea nitrogen and creatinine clearance in the 0.5 g/kg AGE treated-animals were only partially restored. Kidney sections taken from CsA-treated rats showed severe vacuolations and tubular necrosis. These histopathological changes were markedly improved by pretreatment of rats with AGE at the dose of 0.5--2 g/kg. The results indicate that AGE ameliorates renal dysfunction and morphological changes induced by CsA, and imply that it could be a beneficial remedy for attenuating the CsA nephrotoxicity.