Table 3.
CAM treatments for the control of UTs.
| Intervention | Route, Dosage, and Frequency | Author/Year | Mechanism/Usage | Study Design | Subjects | Subject Number | Result |
|---|---|---|---|---|---|---|---|
| Clinical Studies | |||||||
| Curcuma longa and Boswellia serrata | Oral, 1 capsule, BID | Moreillon et al., 2013 [91] | Anti-inflammation, inhibition of NF-Κb and MAPK | RCT | Patients with CKD | 16 | IL-6 ↘ |
| UCG | Oral, 5 g, TID and 10 g HS | Zheng et al., 2017 [95] | Anti-inflammation and antifibrosis | RCT | Patients with CKD | 292 | Cr ↘ |
| Acupuncture | External, LI4, ST36 and KI3, 1 time/week | Yu et al., 2017 [92] | Improving renal local microcirculation | RCT | Patients with CKD | 59 | Cr ↘ |
| Moxibustion | External, 0.5~7 sessions/week | Zhou et al., 2020 [93] | Dilating local renal capillaries, alleviating kidney podocyte injury | MA | Patients with CKD | 1571 | BUN ↘, Cr ↘ |
| Animal Studies | |||||||
| DFD | Gastric gavage, 2.5 g/kg, QD | Tu et al., 2014 [96] | Inhibiting apoptosis by blocking TGF-b1-JNK | Animal | Adenine-induced renal injury rats | 27 | BUN ↘, Cr ↘, UA ↘ |
| DHI and salvianolic acids | Extracorporeal, DHI 4.16 mL/kg or LA 24.69 mg/kg, once | Li et al., 2019 [97] | Protein-binding competitors | Animal | CKD rats with accumulated IS and pCS | 16 | Enhanced dialysis removal of IS and pCS |
| UCG | Gastric gavage, 5 g/kg, QD | Huang et al., 2014 [98] | Antifibrosis, regulation of ECM degradation | Animal | Adenine and UUO-induced renal failure rats | 26 | BUN ↘, Cr ↘, UA ↘ |
| ZDW | i.p., 2 g/kg, once | Hsu et al., 2014 [99] | Attenuation of apoptosis through limiting of caspase-3 activation | Animal | Gentamicin-induced renal injury rat |
12 | BUN ↘Cr ↘ |
| ZDW | Embryo exposure, 100 ppm, once | Lu et al., 2020 [100] | Suppression of proinflammatory gene expression | Animal | AA-intoxicated zebrafish embryos | 150 | tnf-α ↘ |
| Catechin | Oral, 100 mg/kg, QD | Korish et al., 2008 [101] | Antioxidation | Animal | 5/6 nephrectomy rats | 40 | ADMA ↘ |
| Cyanidin-3-O-glucoside (C3G) | i.p., 20 mg/kg, QD | Qin et al., 2018 [102] | Antioxidation | Animal | db/db mice with DN | 60 | BUN ↘, Cr ↘ |
| EGCG | i.p., 50 mg/kg, QD | Wang et al., 2015 [103] | Anti-inflammation and antioxidation through inhibition of the NF-κB signaling pathway and activation of the Nrf2-Keap1 pathway | Animal | UUO mice | 24 | BUN ↘, Cr ↘ |
| Gypenoside (GP) | i.v., 50 mg/kg, once | Ye et al., 2016 [104] | Attenuating inflammatory and oxidative stress by inhibiting ERK signaling | Animal | I/R-induced renal injury mice | 30 | BUN ↘, Cr ↘, IL-1β ↘, IL-6 ↘, MDA ↘, TNF-α ↘ |
| Huangkui capsule | Gastric gavage, 0.75 g/kg, QD | Cai et al., 2017 [105] | Inhibition of the NADPH oxidase/ROS/ERK pathway | Animal | Adenine-induced CRF Rats | 18 | BUN ↘, Cr ↘ |
| Huangkui capsule | Gastric gavage, 0.675 g/kg, QD | Wang et al., 2019 [106] | Inhibition of the transformation of Trp to indole | Animal | 5/6 nephrectomy Rats | 21 | IS ↘ |
| Leonurine (LEO) | i.v., 50 mg/kg, QD | Xu et al., 2014 [107] | Inhibition of inflammatory and oxidative stress through downregulation of NF-kB | Animal | LPS-induced renal injury mice | 120 | BUN ↘, Cr ↘, IL-1 ↘, IL-6 ↘, IL-8 ↘, MDA ↘, TNF-α ↘ |
| Ligustrazine (LIG) | i.p., 80 mg/kg, once | Feng et al., 2011 [108] | Downregulation of oxidative stress and apoptosis, decrease in neutrophil infiltration | Animal | I/R-induced renal injury mice | 48 | MDA ↘, TNF-α ↘ |
| Notoginsenoside R1 (NR1) | i.p., 80 mg/kg, once | Liu et al., 2010 [109] | Blocking apoptosis and inflammatory response by suppressing p38 and NF-kB | Animal | I/R-induced renal injury rats | 24 | Cr ↘, TNF-α ↘ |
| Osthole | i.p., 40 mg/kg, once | Luo et al., 2016 [110] | Abrogating inflammation by suppressing JAK2/STAT3 signaling, activating PI3K/Akt signaling | Animal | I/R-induced renal injury rats | 70 | BUN ↘, Cr ↘, IL-6 ↘, TNF-α ↘ |
| Paeoniflorin (PF) | i.p., 30 mg/kg, once | Liu et al., 2015 [111] | Attenuation of inflammatory response by inhibiting CXCR3/CXCL | Animal | ConA-induced renal injury mice | 60 | BUN ↘, Cr ↘, IL-1β ↘ |
| Resveratrol | Gastric Gavage, 1 mg/kg, QD | Chen et al., 2016 [112] | Modulation of intestinal microbiota | Animal | ApoE(-/-) mice | 20 | TMAO ↘ |
| Tanshinone I | i.p., 120 mg/kg, QD | Feng et al., 2013 [113] | Enhancement of AAI metabolism by induction of CYP1A | Animal | AAI-induced renal injury mice | 40 | BUN ↘, Cr ↘ |
| Rhubarb | Enema, 0.5 g, QD | Lu et al., 2015 [114] | Antioxidation, anti-inflammation | Animal | 5/6 nephrectomy rats | 28 | Cr ↘, IS ↘ |
| Rhubarb | Enema, 2.12 g/kg, QD | Ji et al., 2020 [115] | Modulation of intestinal microbiota, improving the intestinal barrier, anti-inflammation |
Animal | 5/6 nephrectomy rats | 30 | IL-1β ↘, IL-6 ↘ |
| SkQR1 | i.p., 400 nmol/kg, once | Plotnikov et al., 2011 [116] | Antioxidation | Animal | Glycerol-induced rhabdomyolysis rats | 36 | BUN ↘, MDA ↘ |
↘, decrease; AA, aristolochic acid; ADMA, asymmetric dimethylarginine; ApoE, apolipoprotein E; BID, bis in die; BUN, blood urea nitrogen; CKD, chronic kidney disease; ConA, concanavalin A; Cr, creatinine; CRF, chronic renal failure; CXCR3/CXCL, c-X-c motif chemokine receptor 3/C-X-C motif Chemokine ligand; CYP1A, cytochrome P450 1A; DFD, Dahuang Fuzi Decoction; DHI, Danhong injection; DN, diabetic nephropathy; ECM, extracellular matrix; EGCG, eepigallocatechin-3-gallate; ERK, extracellular signal-regulated kinase; HS, hora somni; i.p., intraperitoneal injection; I/R, ischemia/reperfusion; IL-1, interleukin-1; IL-1β, interleukin-1 beta; IL-6, interleukin-6; IS, indoxyl sulfate; JAK2/STAT3, Janus kinase 2/signal transducer and activator of transcription 3; LA, lithospermic acid; MA, meta-analysis; MAPK, mitogen-activated protein kinase; MDA, malondialdehyde; NADPH, nicotinamide adenine dinucleotide phosphate; NFκB, nuclear factor kappa B; Nrf2-keap1, nuclear factor E2-related factor 2-Kelch-like ECH-associated protein 1; PCS, p-cresyl sulphate; PI3K/Akt, phosphatidylinositol 3-kinase/Ak strain transforming; QD, quaque die; RCT, randomized controlled trial; ROS, reactive oxygen species; SkQR1, 10-(6′-plastoquinonyl) decylrhodamine; TGF β1-JNK, transforming growth factor-beta-1-c-Jun N-terminal kinase; TID, ter in die; TMAO, trimethylamine N-oxide; TNF-α, tumor necrosis factor alpha; UA, uric acid; UCG, uremic clearance granule ; UUO, unilateral ureteral obstruction; ZDW, Zhibai Dihuang Wan.