Effect of Herbal Preparation Canephron® N on the Course of Diabetic Nephropathy in Patients with Diabetes Mellitus Type 2: Results of a Comparative Cohort Study

Main Article Content

L.P. Martyniuk
Lar.P. Martyniuk
O.A. Ruzhitskaia
Ye.S. Martyniuk


The Objective of the Study. Diabetic nephropathy (DN) is a severe and common complication of diabetes mellitus, leading to end-stage renal failure in 30 % of patients with diabetes mellitus. The first manifestation of DN is microalbuminuria, which arises due to a decrease in glomerular filtration barrier function for albumin. In violation of this function, key roles belong to reactive oxygen species, inflammatory cytokines and growth factors.
Experimental Procedures. In this study, patients with DN received complex herbal preparation Canephron® N to study its effect on the dynamics of microalbuminuria and the overall status of the antioxidant defense system. An open study involving 59 patients has been carried out to compare the efficacy of Canephron® N in conjunction with standard antidiabetic therapy and angiotensin-converting enzyme (ACE) inhibitor, with standard therapy and treatment with ACE inhibitor alone.
Results. After 6-month therapy, in the study group microalbuminuria level significantly decreased compared with the control group. Canephron® N has a positive impact on the status of antioxidant defense and levels of lipid peroxidation. Furthermore, the content of the liver transaminases has not changed.
Conclusions. Given the excellent tolerability of Canephron® N, the findings allow us to recommend conclusively this herbal medicine to the patients with DN as additional therapy.

Article Details

How to Cite
Martyniuk, L., L. Martyniuk, O. Ruzhitskaia, and Y. Martyniuk. “Effect of Herbal Preparation Canephron® N on the Course of Diabetic Nephropathy in Patients With Diabetes Mellitus Type 2: Results of a Comparative Cohort Study”. KIDNEYS, no. 1.11, Feb. 2015, pp. 24-32, doi:10.22141/2307-1257.
Original Articles


Fowler M.J. Microvascular and macrovascular complications of diabetes // Clin. Diabetes. 2011, 29: 116-122.

Turner R.C., Millns H., Neil H.A. et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS:23) // Br. Med. J. 1998; 316: 823-828.

United States Renal Data System // Am. J. Kidney Dis. 2003; 42: 1-230.

Birn H., Christensen E.I. Renal albumin absorption in physio­logy and pathology // Kidney Int. 2006; 69: 440-449.

Mogensen C.E., Chachati A., Christensen C.K. et al. Microalbuminuria: an early marker of renal involvement in diabetes // Renal Fail. 1985; 9: 85-95.

Glassock R.J. Is the presence of microalbuminuria a relevant marker of kidney disease? // Curr. Hypertens. Rep. 2010, 12: 364-368.

Dinneen S.F., Gerstein H.C. The association of microalbuminuria and mortality in non-insulin-dependent diabetes mellitus. A systematic overview of the literature // Arch. Intern. Med. 1997; 157: 1413-1418.

Gerstein H.C., Mann J.F., Yi Q. et al., HOPE Study Investigators. Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals // JAMA 2001; 286: 421-426.

Allen K.V., Walker J.D. Microalbuminuria and mortality in long-duration type 1 diabetes // Diab. Care 2003; 26: 2389-2391.

Adler A.I., Stevens R.J., Manley S.E. et al. Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64) // Kidney Int. 2003; 63: 225-232.

Satchell S.C., Tooke J.E. What is the mechanism of microalbuminuria in diabetes: a role for the glomerular endothelium? // Diabetologia 2008; 51: 714-725.

Pandey K.B., Rizvi S.I. Markers of oxidative stress in erythrocytes and plasma during aging in humans // Oxid. Med. Cell. Longev. 2010; 3: 2-12.

Cvetkovic T., Mitic B., Jevtovic S. et al. Lipid peroxidation and total SH group in patients with different forms of glomerulonephritis // Acta Fac. Med. Naiss. 2007; 24: 165-169.

Gradinaru D., Borsa C., Ionescu C., Margina D. Advanced oxidative and glycoxidative protein damage markers in the elderly with type 2 diabetes // J. Proteomics 2013; 92: 313-322.

Bailey C.J., Day C. Traditional plant medicines as treatments for diabetes // Diabetes Care 1989; 12: 553-564.

Khan A., Safdar M., Ali Khan M.M. et al. Cinnamon improves glucose and lipids of people with type 2 diabetes // Diabetes Care 2003; 26: 3215-3218.

Ivanov D., Nazarenko V., Kushnirenko S. et al. Phytotherapy of metanolic syndrome with diabetes mellitus type 2. Therapeutic possibilities of phytoneering // Medichna gazeta Zdoro’ve Ukraini 21 storichcha [Health of the Ukraine] 2005; 17: 46-47.

Ivanov D., Nazarenko V., Kushnirenko S. et al. Therapeutic opportunities of preparation Canephron N in treatment of urinary tract infections at patients with diabetes 2 types and a metabolic syndrome // Medichna gazeta Zdoro’ve Ukraini 21 storichcha [Health of the Ukraine 21st Century]: 2004: 28.

Ivanov D., Nazarenko V., Kushnirenko S. et al. Therapeutic opportunities of preparation Canephron N in treatment of urinary tract infections at patients with diabetes 2 types and a metabolic syndrome // Kachestvo jizni. Medicina [Quality of Life. Medicine.] 2006; 3: 99-102.

Dham S., Shah V., Hirsch S., Banerji M.A. The role of complementary and alternative medicine in diabetes // Curr. Diab. Rep. 2006; 6: 251-258.

Samad A., Shams M.S., Ullah Z. et al. Status of herbal medicines in the treatment of diabetes: a review // Curr. Diabetes Rev. 2009: 5: 102-111.

Suksomboon N., Poolsup N., Boonkaew S., Suthisisang C. Meta-analysis of the effect of herbal supplement on glycemic control in type 2 diabetes // J. Ethnopharmacol. 2011; 137: 1328-1333.

Haloui M., Louedec L., Michel B., Lyoussi B. Experimental diuretic effects of Rosmarinus officinalis and Centaurium erythraea // J. Ethnopharmacol. 2000; 71: 465-472.

Yarnell E. Botanical medicines for the urinary tract // World J. Urol. 2002; 20: 285-293.

Abdul-Ghani A.S., El-Lati S.G., Sacaan A. et al. Anticonvulsant effects of some Arab medicinal plants // Int. J. Crude Drug Res. 1987; 25: 39-43.

Yamahara J., Konoshima I., Sawada I., Fujimura H. Biologically active principles of crude drugs: pharmacological actions of Swertia japonica extracts, swertiamarine and gentianine // Yakugaku Zasshi 1978; 98: 1446-1451.

Gracza L., Koch H., Loffler E. Isolierung von Rosmarinsaure aus Symphytum officinale und ihre antiinflammatorische Wirksamkeit in einem in vitro-Modell // Arch. Pharm. 1985; 318: 1090-1095.

Rampart M., Beetjens J.R., Bult H. et al. Complementdependent stimulation of prostacyclin biosynthesis; inhibition by rosmarinic acid // Biochem. Pharmacol. 1986; 35: 1397-1400.

Valentao P., Fernandes E., Carvalho F. et al. Hydroxyl radical and hypochlorous acid scavenging activity of small centaury (Centaurium erythraea) infusion. A comparative study with green tea (Camellia sinensis) // Phytomedicine 2003; 10: 517-522.

European Scientific Cooperative on Phytotherapy. Centaurii herba (Centaury herb) // ESCOP Monographs. 2nd ed. Stuttgart, Germany, New York: Thieme-Verlag, 2003: 70-73.

European Scientific Cooperative on Phytotherapy. Rosmarini folium (Rosemary leaves) // ESCOP Monographs. 2nd ed. Stuttgart, Germany, New York: Thieme-Verlag; 2003: 429-436.

Kumarasamy Y., Nahar L., Cox P.J. et al. Bioactivity of secoiridoid glycosides from Centaurium erythraea // Phytomedicine 2003; 10: 344-347.

Kumarasamy Y., Nahar L., Sarker S.D. Bioactivity of gentiopicroside from the aerial parts of Centaurium erythraea // Fitoterapia 2003; 74: 151-154.

Sterner W., Heisler E., Popp H.O., Fischer H. Studien uber die Canephron-Wirkung bei chronischen Nierenerkrankungen // Physikalische Medizin Rehabilitation 1973; 14: 239-258.

Gaybullaev A.A., Kariev S.S. Effects of the herbal combination Canephron N on urinary risk factors of idiopathic calcium urolithiasis in an open study // Z. Phytother. 2013; 34: 16-20.

Naber K.G. Efficacy and safety of the phytotherapeutic drug Canephron N in prevention and treatment of urogenital and gestational disease: review of clinical experience in Eastern Europe and Central Asia // Res. Rep. Urol. 2013; 5: 39-46.

Alberti K.G., Zimmert P.Z. Definition, diagnosis and classification of diabetes mellitus and its complications: Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation // Diab. Med. 1998; 15: 539-553.

Gavrilov V., Mishkorudnaya M. Spectrophotometric determination of lipid hyperoxides in blood plasma // Laboratornoe delo [Laboratory work] 1983; 29: 33-35.

Ellman G.L. Tissue sulfhydryl groups // Arch. Biochem. 1959; 82: 70-72.

Chevari S., Andyal T., Shtrenger Y.A. Determination of antioxidant parameters of blood and their significance in old age // Laboratornoe delo [Laboratory work] 1991; 37: 9-13.

Koroluy M., Ivanova L., Majorova I. Metod opredeleniya aktivnosti katalazi // Laboratornoe delo [Laboratory work] 1988; 34: 16-19.

Krolewski A.S., Warram J.H., Christlieb A.R. Hypercholesterolemia — a determinant of renal function loss and deaths in IDDM patients with nephropathy // Kidney Int. 1994; 45: S125-131.

Yokoyama H., Tomonaga O., Hirayama M. et al. Predictors of the progression of diabetic nephropathy and the beneficial effect of angiotensin-converting enzyme inhibitors in NIDDM patients // Diabetologia 1997; 40: 405-411.

Piwowar A., Knapik-Kordecka M., Warwas M. AOPP and its relations with selected markers of oxidative/antioxidative system in type 2 diabetes mellitus // Diabetes Res. Clin. Pract. 2007; 77: 188-192.

Himmelfarb J., McMongale E., McManamin E. Plasma protein thiol oxidation and carbonyl formation in chronic renal failure // Kidney Int. 2000, 58: 2571-8.

Small D.M., Coombes J.S., Bennett N. et al. Oxidative stress, anti-oxidant therapies and chronic kidney disease // Nephrology 2012; 17: 311-321.

Ranasinghe P., Jayawardana R., Galappaththy P. et al. Efficacy and safety of «true» cinnamon (Cinnamomum zeylanicum) as a pharmaceutical agent in diabetes: a systematic review and meta-analysis // Diabet. Med. 2012; 29: 1480-1492.

Sychev D.A., Semenov A.V., Polyakova I.P. A case of hepatic injury suspected to be caused by Canephron N, a Centaurium Hill containing phytotherapeutics // Int. J. Risk Saf. Med. 2011; 23: 5-6.