Nephrology Dialysis Transplantation, Vol 12, Issue 1 81-86, Copyright © 1997 by Oxford University Press
F Reginster, M Jadoul and C van Ypersele de Strihou
Background. Chinese herbs nephropathy is a new type of
subacute interstitial nephropathy reported in women who had followed a
slimming regimen including Chinese herbs. Methods. We
report the clinical presentation and follow-up of 15 cases and compare them
with a control group of 15 women with interstitial nephropathies of other
origins, matched for age, sex, and initial serum creatinine (mean 3 mg/dl).
Results. At presentation the Chinese herbs nephropathy
group differed from the control group by a lower proteinuria (P=0.009), a
more severe anaemia (P=0.002), and a higher prevalence of aortic
insufficiency (42% vs 0%, P <0.005). It was further characterized by
mild hypertension in 80%, glycosuria and leukocyturia in 40% and asymmetric
kidneys in 43% of the cases. During follow-up, deterioration of renal
function was faster in the Chinese herbs nephropathy than in the control
group (P <0.05). It was influenced by the duration of Chinese herbs
treatment (P=0.037) and the delay between the end of Chinese herbs
ingestion and diagnosis of the disease (P-0.013). In three cases, renal
failure developed 3 years after Chinese herbs ingestion. Complications
included severe aortic regurgitation requiring surgery (n=1), urothelial
carcinoma (n=2), bilateral ureterohydronephrosis due to periureteral
fibrosis (n=1). Five patients with Chinese herbs nephropathy were
successfully transplanted, without evidence of recurrence of the disease.
Conclusion. Chinese herbs nephropathy is characterized
by a lower proteinuria, more severe anaemia, and a faster progression of
renal failure than other interstitial nephropathies. The duration of
Chinese herbs treatment and interval between withdrawal of Chinese herbs
and diagnosis are correlated with the rate of progression. Severe, unusual
extrarenal complications may affect Chinese herbs nephropathy patients.
Keywords. aristolochic acid; Chinese herbs; Chinese
herbs nephropathy; interstitial nephropathy
ORIGINAL ARTICLES
Chinese herbs nephropathy presentation, natural history and fate after transplantation
Cliniques Universitaires St-Luc, Department of Nephrology, av. Hippocrate 10, 1200 Bruxelles, Belgium; Corresponding author
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