Effect of Astragalus membranaceus Extract Combined with Nursing Intervention on Serum Inflammatory Factors and Therapeutic Effects in Patients with IgA Nephropathy

Background and Objectives: IgA nephropathy is a common immunologically mediated kidney disease. This work investigated the impact of Astragalus membranaceus Extract (AME) combined with nursing intervention on serum inflammatory factors in patients with IgA nephropathy and its potential influence on treatment outcomes. Materials and Methods: AME was analyzed by High Performance Liquid Chromatography (HPLC) and Ultraviolet spectrophotometry (UV) to determine its active components and content. A total of 153 patients with biopsy-confirmed IgA nephropathy were randomly rolled into three groups: control group (treated with irbesartan), NI group (treated with irbesartan, placebo and nursing intervention) and AME group (treated with irbesartan, AME therapy and nursing intervention). After 2 months, clinical efficacy, serum inflammatory factors, renal function parameters and safety were evaluated across the three groups. Results: Analysis revealed that the main components of AME were Calycosin-7- glucoside (C7G, 152.4 mg), Astrapterocarpan (117.4 mg), Ononin (97.8 mg) and Calycosin (47.4 mg). The total flavonoid content was 46% determined by HPLC or 50% measured using UV. After two months of treatment, the Total Effective Rate (TER) in the AME group was significantly higher than that in control group and NI group (p<0.05). Before treatment, there were no significant differences among the three groups in levels of Tumor Necrosis Factor-α (TNF-α), Interleukin-6 (IL-6), Interleukin-15 (IL-15), high-sensitivity C-Reactive Protein (hs-CRP), Monocyte Chemoattractant Protein-1 (MCP-1), or Transforming Growth Factor-β1 (TGF-β1) (p>0.05). After treatment, serum concentrations of inflammatory factors decreased in all groups, with the AME group showing a significantly greater reduction (p<0.05), except for TGF-β1, which showed no significant difference (p>0.05). Similarly, no significant differences were observed in renal function parameters, including 24-hr Urinary Protein excretion (24 hr-Upro), Serum creatinine (Scr), Blood Urea Nitrogen (BUN) and Abnormal urinary Red Blood Cell count (ARBC), among the three groups before treatment (p>0.05). Following treatment, all renal function parameters improved, with values in the AME group significantly lower than those in the control group and NI group (p<0.05). However, there were no notable changes in estimated Glomerular Filtration Rate (eGFR) before and after treatment across all groups (p>0.05). Additionally, the 1-year cumulative renal survival rate in the AME group was significantly higher than in the other groups (p<0.05). The Incidence of Adverse Reactions (IoAR) showed no significant difference among the groups (p>0.05). Conclusion: AME combining with nursing intervention exerted an improving effect in clinical symptoms and renal function of patients with IgA nephropathy by hindering inflammatory factors in conjunction. Further research into the mechanism underlying AME treatment for IgA nephropathy may offer strong support for developing new strategies and medications, leading to better clinical outcomes for patients.