Efficacy of Rikkunshito for functional dyspepsia in hemodialysis patients based on diabetic nephropathy

【Purpose】 Hemodialysis patients with diabetic nephropathy often have functional dyspepsia (FD) due to gastrointestinal dysfunction. Recently, Rikkunshito, a kampo preparation, was reported to be useful for FD. In this study, we aimed to examine the clinical effects of Rikkunshito on hemodialysis patients with diabetic nephropathy who had FD. 【Methods】 A total of 15 hemodialysis patients with diabetic nephropathy, whose symptoms of FD could not be improved by the administration of omeprazole (20 mg/day) for more than 6 months, were studied. The Gastrointestinal Symptom Rating Scale (GSRS) with the questions for FD and WHOQOL26 were used to assess the patients' gastrointestinal symptoms and everyday quality of life (QOL) before and 4 weeks after the administration of Rikkunshito. 【Results and Conclusions】 Not only the symptoms of FD, but also abdominal pain, acid reflux, disturbed digestion, diarrhea, and constipation were significantly improved in the GSRS evaluation. The psychological and general life scores were significantly improved on WHOQOL26 evaluation. Labolatory data showed a significant increase in total protein, and the cardiothoracic ratio was markedly reduced. These results suggest that the nutritional condition could be improved by Rikkunshito. Rikkunshito can be selected as a safe and efficient treatment for such functional gastrointestinal diseases as FD in hemodialysis patients with diabetic nephropathy.