2017 年 43 巻 8 号 p. 407-416
Although some have reported that Astragali Radix, which has a diuretic effect and is contained in herbal preparations for kidney disorders, suppresses the progress of renal dysfunction, its effects on chronic-phase patients after renal transplantation have not been verified. Therefore, the effect of Astragali Radix on improving the creatinine levels of patients with chronic kidney allograft dysfunction (CKAD) and the possibility of its interaction with immunosuppressants were studied. The subjects were 13 patients who had received living-donor kidney transplantation at our hospital for stage 4/5 chronic kidney diseases (CKD) and agreed to cooperate in the study. Their serum creatinine (sCr) level, which was 3.6 ± 0.8 mg/dL before Astragali Radix administration, decreased significantly by 1 month later and was 3.0 ± 0.7 mg/dL after 3 months, resulting in a significantly increased estimated glomerular filtration rate (eGFR). In all cases, the 1/sCr level after Astragali Radix administration exceeded the value estimated from the approximate line obtained by plotting the pre-administration 1/sCr levels on the administration period. The area under the curve (AUC) of blood concentration standardized by dose for 12 hours after immunosuppressant administration increased by approximately 20％ for tacrolimus (TAC) after Astragali Radix administration, but did not change significantly for mycophenolic acid (MPA), which is an active metabolite of mycophenolate mofetil (MMF). Astragali Radix reduced sCr significantly and suppressed the progress of CKAD. Since the blood TAC level increase caused by Astragali Radix was not clinically significant, it was considered safe for use in combination with TAC or MMF.
