The Traditional Japanese Medicine (Kampo) Boiogito has a Dual Benefit in Cardiorenal Syndrome : A Pilot Observational Study

Background:Conventional treatment for cardiorenal syndrome (CRS) is frequently associated with drug resistance and limited clinical success.We aimed to explore a new approach utilizing Boiogito (TJ-20), a traditional Japanese medicine(Kampo),in combination with conventional treatment for patients with CRS. Methods and Results:We enrolled 26 patients with CRS (18 men;mean age,77±8.4 years;mean serum brain natriuretic peptide(BNP),241.5±196.6 pg/mL;mean estimated glomerular filtration rate(eGFR),40.02±10.54 mL.min .1.73 m ). Treatment with TJ-20 was started at an average dose of 4.6±1.5 g/day, which was increased to 5.2±1.2 g/day at 3.5 months and to 5.9±1.5 g/day at 9.4 months.TJ-20 treatment significantly increased mean eGFR (mL.min .1.73 m )to 44.60±10.76 at 3.5 months (P=0.001),and to 45.93±11.57 at 9. 4 months (P=0.0004).In addition,the New York Heart Association functional classification improved (P=0. 019),and serum BNP levels decreased significantly to 195.5±145.7 pg/mL at 3.5 months(P=0.008)and to 163. 3±130.2 pg/mL at 9.4 months (P=0.007).The increase in eGFR had no correlation with the decrease in BNP level,indicating independent effects on both renal function and heart failure status. Conclusions:TJ-20 can benefit both renal function and heart failure status in patients with CRS.Alternative medicine utilizing TJ-20 may provide a novel and useful strategy for the difficult management of patients with CRS.