For These 6 Types Of Kidney Disease, Flunomide Can Be Used To Reduce Urinary Protein!

Leflunomide is one of a series of fluorine-containing chemical structures synthesized by the German company Hoeschst in the late 1970s during the development of agricultural pesticides. Leflunomide has anti-proliferative and immunosuppressive effects and has made many contributions in the clinical field of rheumatology and immunity, such as improving adult rheumatoid arthritis, and can also be used in patients with lupus nephritis.

Click to Cistanche for kidney disease

In recent years, Leflutide has also been well-known and used in the field of nephrology. Clinical studies have found that it can be used to treat immune-mediated kidney diseases, such as small vessel vasculitis renal damage, IgA nephropathy, refractory nephrotic syndrome, and renal transplant rejection. reaction etc. In 1999, the National Medical Products Administration (NMPA) approved leflunomide for marketing in China [1].

The mechanism of leflunomide

It is a prodrug that can be quickly and completely converted into the active metabolite malonitramide after taking it. It can inhibit the activity of dihydrolactate dehydrogenase in mitochondria, stop lymphocyte proliferation, and limit cell membrane synthesis. The synthesis and secretion of antibodies and lymphokines are inhibited. Leflunomide stops the proliferation of B lymphocytes and T lymphocytes in the Gl phase, thus inhibiting lymphocyte-mediated cellular and humoral immune responses.

Application in immune kidney diseases

1 Lupus nephritis

When treating patients with type III and type IV active lupus nephritis, leflunomide and glucocorticoids can be used in combination to control the disease. Studies have found that when treating lupus nephritis, the use of leflunomide on the basis of combined treatment with cyclophosphamide + prednisone can reduce kidney damage [2].

Induction period: 20mg/d~40mg/d, generally 30mg/d is chosen, and the treatment time is 6~9 months.

Maintenance period: 20mg/d. If remission is maintained for a long time, the dose can be reduced to 10mg/d as appropriate. The course of treatment is at least 2 years.

For patients with renal insufficiency whose serum creatinine exceeds 1.5 times the upper limit of normal, the dosage may be reduced as appropriate.

2 Primary small vessel vasculitis nephritis

For patients who are ineffective or intolerant to cyclophosphamide, leflunomide can be used.

Induction remission period: Leflunomide 20mg/d~30mg/d can replace azathioprine or methotrexate, and is suitable for patients with ANCA-related vasculitis in the maintenance period who have poor efficacy or intolerance to the first two.

3 IgA nephropathy

The combination of leflunomide and moderate-dose glucocorticoids can reduce proteinuria in patients with IgA nephropathy, reduce the dosage of combined hormones, increase serum albumin, and continuously stabilize renal function. For patients who take renin-angiotensin-aldosterone (RAAS) system drugs that are ineffective in improving proteinuria, they can also be switched to leflunomide, with a starting dose of 20mg/d~30mg/d. After achieving complete clinical remission, leflunomide can be used. Change to 10mg/d maintenance treatment, with a course of treatment of at least 6 months.

4 Refractory nephrotic syndrome

Patients with nephrotic syndrome present with massive proteinuria and dyslipidemia, and some patients may also experience hematuria. Leflunomide combined with glucocorticoids can improve the above symptoms. It is recommended to use leflunomide in combination with glucocorticoids to treat refractory nephrotic syndrome, with a starting dose of 20 mg/d~30 mg/d and a treatment course of at least 6 months.

5 Purpura nephritis

Leflunomide and small to medium doses of glucocorticoids can significantly reduce urinary protein and improve hematuria in patients with purpura nephritis. The recommended starting dose for combined use is 10mg/d~20mg/d. After complete clinical remission is achieved, the dosage can be changed. Maintenance treatment is 5mg/d~10mg/d, and the course of treatment is at least 6 months.

6 kidney transplant

There are many anti-immune drugs used after kidney transplantation, such as cyclosporine A, tacrolimus, glucocorticoids, etc. Leflunomide can also be used in patients after transplantation, and active metabolism needs to be maintained when taking it. The blood concentration of the product is 50 μg/ml, so blood concentration monitoring is also required.

Application Notes

1. When taking Leflunomide, you need to check your liver and kidney function regularly. Leflunomide is not affected by hemodialysis and renal function damage, and does not harm the liver. However, because it affects liver metabolism and bile secretion, it can cause serious liver diseases. Leflunomide is contraindicated in patients, especially those with hepatitis B and hepatitis C.

2. The recommended monitoring cycle is: within 3 months of medication, test every 2 to 4 weeks; during 3 to 6 months of medication, test every 8 to 12 weeks; if medication exceeds 6 months, test every 12 weeks.

3. Live immune vaccines cannot be administered while taking the medicine.

4. Leflunomide can be taken on an empty stomach or with food.

summary

Leflunomide is not only widely used in autoimmune diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), granulomatous vasculitis (GPA), Sjogren's syndrome (SS), multiple Dermatomyositis (PM), ankylosing spondylitis (AS), and with the continuous development of leflunomide, it is also widely used in nephrology. This is an inexpensive and fast-acting drug, but it is also a prescription drug and should be used rationally under the guidance of a doctor [3].

How Does Cistanche Treat Kidney Disease?

Cistanche is a traditional Chinese herbal medicine used for centuries to treat various health conditions, including kidney disease. It is derived from the dried stems of Cistanche deserticola, a plant native to the deserts of China and Mongolia. The main active components of cistanche are phenylethanoid glycosides, echinacoside, and acteoside, which have been found to have beneficial effects on kidney health.

Kidney disease, also known as renal disease, refers to a condition in which the kidneys are not functioning properly. This can result in a buildup of waste products and toxins in the body, leading to various symptoms and complications. Cistanche may help treat kidney disease ase through several mechanisms.

Firstly, cistanche has been found to have diuretic properties, meaning it can increase urine production and help eliminate waste products from the body. This can help relieve the burden on the kidneys and prevent the buildup of toxins. By promoting diuresis, cistanche may also help Reduce high blood pressure, a common complication of kidney disease.

Moreover, cistanche has been shown to have antioxidant effects. Oxidative stress, caused by an imbalance between the production of free radicals and the body's antioxidant defenses, plays a key role in the progression of kidney disease. ies help neutralize free radicals and reduce Oxidative stress, thereby protecting the kidneys from damage. The phenylethanoid glycosides found in cistanche have been particularly effective in scavenging free radicals and inhibiting lipid peroxidation.

Additionally, cistanche has been found to have anti-inflammatory effects. Inflammation is another key factor in the development and progression of kidney disease. Cistanche's anti-inflammatory properties help reduce the production of pro-inflammatory cytokines and inhibit the activation of inflammation mandatory pathways, thus alleviating inflammation in the kidneys.

Furthermore, cistanche has been shown to have immunomodulatory effects. In kidney disease, the immune system can be dysregulated, leading to excessive inflammation and tissue damage. Cistanche helps regulate the immune response by modulating the production and activity of immune cells, such as T cells and macrophages. This immune regulation helps reduce inflammation and prevent further damage to the kidneys.

Moreover, cistanche has been found to improve renal function by promoting the regeneration of renal tubes with cells. Renal tubular epithelial cells play a crucial role in the filtration and reabsorption of waste products and electrolytes. In kidney disease, these cells can be damaged, leading to damaged renal function. Cistanche's ability to promote the regeneration of these cells helps restore proper renal function and improve overall kidney health.

In addition to these direct effects on the kidneys, cistanche has been found to have beneficial effects on other organs and systems in the body. This holistic approach to health is particularly important in kidney disease, as the condition often affects multiple organs and systems. che has been shown to have protective effects on the liver, heart, and blood vessels, which are commonly affected by kidney disease. By promoting the health of these organs, cistanche helps improve overall kidney function and prevent further complications.

In conclusion, cistanche is a traditional Chinese herbal medicine used for centuries to treat kidney disease. Its active components have diuretic, antioxidant, anti-inflammatory, immunomodulatory, and regenerative effects, which help improve renal function and protect the kidneys from further damage. , cistanche has beneficial effects on other organs and systems, making it a holistic approach to treating kidney disease.