Objective To clarify the dosage effect relation of Yan Shen Capsule to retard remnant kidney progressive damage. Methods 120 adult Wistar rats were randomly divided into 6 groups, 20 rats in each group. Rats in Group A were sham operated, and rats in Groups B, C, D, E and F were 5/6 nephrectomized. After operation, Groups C, D, E were given low (450 mg/kg/d), middle (900 mg/kg/d) and high (1800 mg/kg/d) dosage of Yan Shen capsule into the stomach. Group F was given control drug, Shen Shuai Ning Capsule. Groups A and B were given the same volume of saline. On day 15 and 90 after operation, serum urea (BUN) and creatinine (SCr), hemoglobin (Hb), renal histology under optical microscope and transelectron microscope, and morphometry were observed. Results Ninety days after operation, the concentration of BUN and SCr in Group B was obviously higher and Hb was lower than that in Group A ( P <0.05). The concentration of BUN and SCr in Groups C, D, and E was lower and Hb was higher than that in Group B( P <0.05). The higher the dosage of Yan Shen capsule was, the lower the concentration of BUN and SCr. The concentration of BUN and SCr in Group F was lower than that in Group B but higher than that in Group E. Under optical microscope, the remnant kidney in Group B showed glomerular mesangial cell proliferation, glomerular mesangial matrix dilation, glomerular sclerosis and interstitial fibrosis. The longer the time was after operation, the more serious the renal histological damage.
The morphometry showed that Group B had higher ratio of sclerosis glomeruli and damaged tubules and interstitial than did Group A ( P <0.05). Groups C, D, and E had lower ratio of sclerosis glomeruli and damaged tubules and interstitial than did Group B ( P <0.05). The higher the dosage of Yan Shen capsule was, the lower the ratio of sclerosis glomeruli and damaged tubules and interstitial. Under transelectron microscope, the glomerular mesangial cell proliferation was outstanding in Group B with less apoptosis cells in mesangium. In Groups C, D, and E, glomerular mesangial cell apoptosis was obvious with less proliferative mesangial cells. In Group A, there were neither obvious apotosis nor proliferation in mesangium.Conclusion Yan Shen Capsule could reduce BUN and SCr, inhibit the fibrosis of remnant kidney, and retard the progress of chronic renal failure in dosage dependent manner. Yan Shen capsule has better protective effects on theremnant kidney than Shen Shuai Ning capsule does. Promoting apoptosis of proliferative mesangial cells might be one of the mechanisms that Yan Shen capsule inhibit fibrosis and protects function of remnant kidney.