Protective Effect and Mechanism of Qi Huang Pei Yuan Tang Combined with Reduced Glutathione on Acute Ischemia-Reperfusion Kidney Injury in Rats

Background: Acute renal ischemia-reperfusion injury (R/I) is one of the most important causes of acute kidney injury (AKI) in clinical practice, and its core mechanisms include oxidative stress, inflammatory response and apoptosis. Methods: Fifty healthy male SD rats were randomly divided into five groups: sham-operated group (Sham), model group (R/I), GSH-treated group (XY+R/I), Astragalus Peiyuan Tang group (ZY+R/I), and combined-treatment group (LH+R/I).The R/I model was established by clamping the bilateral renal arteries for 45 minutes, and serum and renal tissue samples were collected at 24 hours after surgery. Statistical analysis: one-way ANOVA was performed using GraphPad Prism 9.5.0, and P<0.05 was considered significant. Results: The results of the study showed that postoperative renal injury was significantly improved in the LH+R/I group of rats, as evidenced by a significant reduction in serum creatinine and urea nitrogen levels; inflammation levels and oxidative stress levels were significantly improved; pathological examination showed that renal tubular epithelial cell detachment and renal mesangial congestion were significantly attenuated in the LH+R/I group; and Western blot analysis showed that the expression of Nrf2, HO-1, and Western blot analysis showed that the expression of Nrf2, HO-1 and GPX4 proteins was significantly up-regulated in the combined treatment group, which further verified that the combined treatment played a protective role by regulating the Nrf2/HO-1 pathway to alleviate oxidative stress. Conclusion: The combined treatment effectively improved renal function and attenuated acute ischemia-reperfusion kidney injury in rats. This study provides a new strategy for combining Chinese and Western medicine in the treatment of acute kidney injury, suggesting that the combination of Chinese medicine compound and antioxidants has the potential for multi-target synergistic effects. Funding: This work was supported by Yunnan Major Scientific and Technological Project, (grant no. 202102AA100060), Yunnan Province's Xingdian Talents Program for Renowned Physicians Support Plan. Funding: Other NIH Support - This work was supported by Yunnan Major Scientific and Technological Project, (grant no. 202102AA100060), Yunnan Province's Xingdian Talents Program for Renowned Physicians Support Plan., Government Support – Non-U.S.