The integrated theraptic effect of the major components of Psidium guajava L. aqueous extracts (PE) (gallic acid, quercetin, EGCG, and rutin) combining with medical trials and control diets on the chronic kidney disease

Chronic kidney disease (CKD) is often found in patients associated with hypertension, hyperlipidemia and obstructive uropathy. Factors attributing to CKD include Glomerulonephritide, infectious inflammation, obesity, genetic disorder and autoimmune diseases. A large majority of CKD may progress to a final stage called the End-Stage Renal Disease (ESRD). Generally, the therapeutic strategy is aiming at slowing down the progression of CKD and preventing the possible complications. Recently, complementary & alternative medicine (CAM) has attracted much attention of many clinical physicians. Previously, we performed a preliminary study (NSC- 98-2320-B-038-024)( Figures 3 & 4), in which we successfully induced CKD in SD rat model by s.c. Doxorubicin 8.5 mg/kg and treated the rat CKD by feeding gallic acid (GA)-containing diet at GA 70mg/kg/day. The CKD rats showed a huge improvement in serum cholesterol (Ch), triglyceride, BUN, creatinine clearance (CCr), oxidative stress and pro-fibrotic factors (IL-6, PDGF), H&E stain revealed GA effectively attenuated nephritis, renal necrosis and amyloidosis. Based on these results, we submit this Three-Year Project. In the first year, the four main constituents in extract of Psidium guajava L. (PE) (gallic acid, quercetin, EGCG, and rutin; GQER) will be straightforwardly used to perform the CAM on CKD rats. In the second year, different medicines clinically applied (MCA) will be used in combination with the GQER (GQER plus MCA), respectively, to see the therapeutic effect of these combined therapy. Based on the results, in the third year we will carry out the experiment of GQER plus MCA when further affected by nutritional facts (NF) especially with respect to the salt (ST) and/or cholesterol (Ch) levels. In this way we will be able to examine the effect of plain CAM in the first year using pure GQER. In the second year, we will examine the effect of CAM plus MCA. And in the third year the effect of CAM plus MCA plus NF of daily diets containing ST+/-Ch in different proportions will be conducted to see to what extent the effect of daily family diet may affect the therapy of CKD. To summarize, from our achievement we will be able to find the effect of different combination of routine clinical therapy/with CAM/plus NF, the treatment course usually applied to a CKD-affiliated OPD patient. Besides, the molecular action mechanisms of GQER with these formulations will be also extensively investigated.