The Traditional Japanese Medicine (Kampo) Boiogito has a Dual Benefit in Cardiorenal Syndrome : A Pilot Observational Study

Abstract

Background : Conventional treatment for cardiorenal syndrome (CRS) is frequently associated with drug resistance and limited clinical success. We aimed to explore a new approach utilizing Boiogito (TJ-20), a traditional Japanese medicine (Kampo), in combination with conventional treatment for patients with CRS.
Methods and Results : We enrolled 26 patients with CRS (18 men ; mean age, 77±8.4 years ; mean serum brain natriuretic peptide (BNP), 241.5±196.6pg/mL ; mean estimated glomerular filtration rate (eGFR), 40.02±10.54mL･min^-1.1.73m^-2). Treatment with TJ-20 was started at an average dose of 4.6±1.5g/day, which was increased to 5.2±1.2g/day at 3.5 months and to 5.9±1.5g/day at 9.4 months. TJ-20 treatment significantly increased mean eGFR (mL･min^-1.1.73m^-2) to 44.60±10.76 at 3.5 months (P＝0.001), and to 45.93±11.57 at 9.4 months (P＝0.0004). In addition, the New York Heart Association functional classification improved (P＝0.019), and serum BNP levels decreased significantly to 195.5±145.7pg/mL at 3.5 months (P＝0.008) and to 163.3±130.2pg/mL at 9.4 months (P＝0.007). The increase in eGFR had no correlation with the decrease in BNP level, indicating independent effects on both renal function and heart failure status.
Conclusions : TJ-20 can benefit both renal function and heart failure status in patients with CRS. Alternative medicine utilizing TJ-20 may provide a novel and useful strategy for the difficult management of patients with CRS.