Wormwood (Artemisia absinthium) for poorly responsive early-stage IgA nephropathy: a pilot uncontrolled trial.
BACKGROUND
Inhibition of the renin-angiotensin system is a widely accepted approach to treat immunoglobulin A (IgA) nephropathy, whereas the role of fish oils as a supplement is controversial. Tumor necrosis factor α (TNF-α) is considered to be involved in the pathophysiologic process of this disorder. Recent in vitro and clinical observations that wormwood can decrease TNF-α levels has led us to investigate the effect of wormwood as a supplement in patients with IgA nephropathy.


METHODS
Pilot uncontrolled trial.


METHODS
10 patients with biopsy-proven IgA nephropathy, normal kidney function, and a history of at least 3 months of proteinuria with protein excretion > 500 mg/d and < 3,500 mg/d despite ongoing dual renin-angiotensin system blockade.


METHODS
The selected patients were given supplements of 1.8 g/d of thujone-free wormwood preparation for 6 months without discontinuing their renin-angiotensin system blockade.


RESULTS
Proteinuria and blood pressure after intervention compared with baseline values.


METHODS
Monthly assessment of urine protein-creatinine ratio and blood pressure during the observation period.


RESULTS
Urine protein-creatinine ratio decreased significantly from 2,340 ± 530 to 315 ± 200 mg/g at the end of the supplementation period (P < 0.001) and was stable during the supplement-free follow-up of another 6 months. Estimated glomerular filtration rate and endogenous creatinine clearance were unchanged during the entire study period. There was a moderate, but significant, decrease (P < 0.002) in mean arterial blood pressure.


CONCLUSIONS
Open uncontrolled trial including a small number of patients.


CONCLUSIONS
Thujone-free wormwood with its favorable safety profile can be an alternative supplement to manage proteinuria in patients with IgA nephropathy.
Krebs
Simone
S
Department of Nuclear Medicine, University of Freiburg, Germany. simone.krebs@uniklinik-freiburg.de
Omer
Bilal
B
Omer
Talib Noor
TN
Fliser
Danilo
D
D000293:Adolescent; D000328:Adult; D031171:Artemisia absinthium; D001794:Blood Pressure / Q000502:physiology; D003404:Creatinine / Q000652:urine; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D005922:Glomerulonephritis, IGA / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D006801:Humans; D008297:Male; D008517:Phytotherapy; D010865:Pilot Projects; D028321:Plant Preparations / Q000627:therapeutic use*; D011507:Proteinuria / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D012084:Renin-Angiotensin System / Q000502:physiology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000502:physiology; D055815:Young Adult
D028321:Plant Preparations; D014409:Tumor Necrosis Factor-alpha; D003404:Creatinine