The Effect of Yishen Jiangzhuo Granules on Serum IFGF23 and CFGF23 in Patients with Chronic Kidney Disease 3-5 Stage

Aim: The objective is to investigate the changes of serum IFGF23 and CFGF23 levels in patients with chronic kidney disease of 3-5 stage before and after treatment by Yishen Jiangzhuo Granules and its clinical significance. Methods: A subset of samples (n=76) from a cohort of patients with CKD of renal function between stage three and five. (Stage 3: n=37; stage 4: n=30; stage 5: n=9). The patients were treated in hospital or in clinic between October 2013 and April 2015 at the nephrology department of Fujian Provincial People's Hospital. Additionally, a total of 30 healthy volunteers were selected in this hospital during the same period as the normal control group. IFGF23, CFGF23 were detected by enzyme-linked immunosorbent assay (ELISA). Calcium (Ca), phosphorus (P), urea nitrogen (BUN), serum creatinine (Scr) was assessed by BECKMAN-C800 automatic biochemical analyzer. Urine creatinine was determined by Reversed Phase High Performance Liquid Chromatography. The endogenous creatinine clearance rate (Ccr) was calculated according to the simplified MDRD formula. Result: The expression levels of serum IFGF23 and CFGF23 did not change significantly before and after drug treatment. But the serum IFGF23 and CFGF23 expression level has been significantly increased in the CKD3 stage, while serum phosphorus levels has not yet increased. Compared with normal group, the expression level of serum IFGF23 and CFGF23 was significantly higher than that of the normal group before and after treatment. Both of them showed a tendency to increase gradually with the decrease of renal function, and the degree of increase of serum IFGF23 expression level was significantly higher than that of CFGF23. Scr and P levels were decreased in CKD 3-5 stage after treatment (P<0.05). In CKD 4-5 stage, after treatment, the serum calcium level was higher than that before treatment (P<0.05). In CKD 3-5 stage, after treatment, the Ccr was higher than that before treatment (P<0.05). Conclusion: IFGF23 increases rapidly with the decrease of Ccr and CFGF23 increases slowly with the decrease of Ccr. In the short term, Yishenjiangzhuo Granules cannot improve serum IFGF23 and CFGF23 levels in CKD 3-5 stage in patients, but it improves the renal function and the metabolism of calcium and phosphorus, and reduces the level of serum creatinine.