Therapeutic effect of the compound centella asiatica in patients with stages 4-5 CKD and its influence on serum α-Klotho and FGF23 levels

Chronic kidney disease (CKD) is a global problem. Many studies have found that the FGF23-Klotho axis plays an important role in the early diagnosis and prognosis of chronic kidney disease, and the compound centella asiatica (CCA) can delay the progression of CKD through the prevention and treatment of renal fibrosis and glomerulosclerosis. Many clinical studies have confirmed that CCA can effectively protect renal function and reduce urinary protein. To explore the therapeutic effect of the CCA in patients with CKD 4–5, and further observe its impact on α-Klotho and FGF23 levels in patient serum. Forty-eight non-dialysis CKD (ND-CKD) patients diagnosed with CKD 4–5, with kidney deficiency, blood stasis, and turbid toxin syndrome, in the Department of Nephrology, Hangzhou Hospital of Traditional Chinese Medicine (TCM) from March 2018 to October 2019, were randomly assigned to the control group and CCA intervention group (CCA group). The control and CCA groups were treated with basic treatment alone or co-treated with CCA, respectively. Changes in Scr, GFR, P, Ca, PTH, FGF23, and Klotho before and after treatment were detected and analyzed. The CCA and control groups were comparable in age, sex, laboratory examination, FGF23 and Klotho. The level of renal function in the CCA group improved after treatment, while the levels of Scr and GFR in the control group were better than before treatment. BUN, Scr, GFR and 24hUP in the CCA group were significantly lower than that in the control group. In the CCA group, the level of serum Klotho after treatment was higher than before, while the level of blood FGF23 after treatment was significantly lower than before, but showed no statistically significant compared to the control group. CCA can effectively improve clinical symptoms, improve renal function, reduce albuminuria, decrease serum FGF23 levels, and increase Klotho levels. The protective effect of CCA may be related to the regulation of the Klotho-FGF23 axis.