Synergistic therapy of enalapril and Cordyceps sinensis in the improvement of renal function in chronic allograft nephropathy patient

Chronic allograft nephropathy (CAN) still remains an important factor that affects the long-term survival of renal recipients. The aim of the study was to investigate synergistic effect of enalapril (an angiotensin converting enzyme inhibitor, ACEI) and Cordyceps sinensis (Bailing capsule, fermented agent of C. sinensis ) on CAN and pursue an effective therapy to control CAN progression. A total of 84 CAN patients who underwent transplantation (live related donor, no prisoners were used in this study) were involved in the study and randomized into four groups. Group A (n=22) received combined treatment of enalapril (10 mg/day) and C. sinensis (2.0 g/per times, three times per day), group B (n=20) was treated with enalapril (10 mg/day), group C (n=21) with C. sinensis (same dose as in group A) and group D (n=21) treated with immunosuppressive agents was set as control. Serum creatinine (SCr), blood urea nitrogen (BUN), creatinine clearance rate (CCr), urinary protein in 24 h (24 h Upro) and urinary transforming growth factor beta 1 (TGF-s 1 ) of all patients were measured before treatment, and at six months after treatment. After treatment for six months, SCr and CCr were improved while 24 h Upro and urinary TGF-s 1 decreased in group A , and SCr improved and 24 h Upro decreased in group C. Patients of group A obtained the highest degree of improvement, and more patients obtained renal improvement and stability than in the other groups. The results of the study show that combined use of enalapril and C. sinensis takes advantages of reducing excretion of urinary protein, improving renal function and retarding CAN progression for CAN patients compared with single use of enalapril or C. sinensis . Keywords: Chronic allograft nephropathy, renal transplantation, enalapril, Cordyceps sinensis