Effects of Ginkgo Biloba Extract (GBE) on Hemostatic Factors and Inflammation in Chronic Peritoneal Dialysis (CPD) Patients

Kim, Su Hee; Lee, Eun Kyoung; Park, Jong Ha; Park, Tae Jin; Choi, Jung; Chang, Jae Won; Kim, Soon Bae

Abstract

BACKGROUND
Disturbances in hemostasis, such as increased fibrinogen, and D-dimer, and increased inflammatory activity may account in part for the higher incidence of cardiovascular events in dialysis patients. GBE is the best selling herbal product in the world. It has been prescribed for cerebral and peripheral vascular diseases. GBE has been reported to affect platelet aggregation, endothelial injury and inflammation. This study was performed to evaluate the effects of GBE on the several hemostatic factors and on inflammation in CPD patients. METHODS: The 66 patients (M 38, F 28; age 53.1+/-10.7 years; median duration of CPD 32 months) enrolled for this prospective study were randomized to 160 mg/day of GBE for 8 weeks (treatment group) or to no medication (control group). RESULTS: There were no between-group differences in age, sex, duration of CPD, presence of diabetes as a cause of ESRD, blood urea nitrogen, serum creatinine, Kt/V, normalized protein catabolic rate, and residual renal function. Bleeding, however, was not detected in the patients. Between baseline and 8 weeks, the PT and aPTT were not significantly altered in either group. GBE decreased plasma D-dimer concentration from 0.92+/-0.59 microgram/mL at baseline to 0.75+/-0.48 microgram/mL at 8 weeks (p<0.01), but that in the control group was not changed. Blood concentrations of fibrinogen, vWF, hs-CRP, albumin, and liver enzyme levels were not significantly changed in both groups. CONCLUSION: GBE was effective in partially reversing the thrombogenic coagulation profile in CPD patients without increasing the risk of bleeding.