The successful treatment of dyspepsia and appetite loss that had proved refractory to gastric secretion inhibitor therapy with rikkunshito in two hemodialysis patients

Abstract

Two hemodialysis patients had difficulties with weight retention and complained of upper gastrointestinal symptoms, such as dyspepsia and nausea. They were administered rikkunshito, a traditional Japanese Kampo medicine, which alleviated their symptoms and increased their appetite and dry weight (DW). Case 1 : A 79-year-old male had been experiencing dyspepsia and loss of appetite for 5 months, and his DW had fallen. A gastric secretion inhibitor was administered, but his symptoms persisted. Following the administration of rikkunshito, his dyspepsia eased, and his appetite gradually recovered. After 1 year, his DW had increased by approximately 7 kg. Case 2 : This case involved a 54-year-old female. Before she was put on hemodialysis, she had a poor appetite and suffered dyspepsia and nausea every summer, and hence, lost weight (approximately 3 kg). When hemodialysis was initiated, her DW was as low as 27 kg. Although a gastric secretion inhibitor was administered, the patient frequently complained of dyspepsia. Following the administration of rikkunshito, her dyspepsia and nausea diminished, and her appetite improved. Summertime weight loss was prevented, and the patient’s DW increased by approximately 5 kg in 2 years. In conclusion, rikkunshito appears to be an effective treatment for weight loss accompanied by upper gastrointestinal symptoms and poor appetite in hemodialysis patients.