Abstract
Background Curcumin, a polyphenolic constituent from Curcuma longa, possesses antioxidant, hypolipidemic, and antidiabetic properties and has been reported to protect against diabetic kidney disease (DKD); however, the effect is inconsistent. Objective This systematic review and meta-analysis aimed to investigate the effect of curcumin supplementation on renal function, lipid profile, blood pressure, and glycemic control in DKD. Methods A systematic and comprehensive literature search of interrelated randomized controlled trials (RCTs) was conducted in PubMed, Embase, Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov from inception to July 30, 2021. Two investigators independently extracted data and assessed the risk of bias. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated to describe the effect sizes using a fixed-effect model. Statistical analysis was performed using STATA 14.0 and RevMan 5.3. Results Five RCTs involving 290 participants with DKD were included. Curcumin supplementation significantly improved the serum creatinine (WMD: −0.16 mg/dL, 95% CI: −0.3 to −0.02, P = 0.029, I2 = 0%, moderate certainty), total cholesterol (WMD: −10.13 mg/dL, 95% CI: −17.84 to −2.14, P = 0.01, I2 = 0%, moderate certainty), systolic blood pressure (WMD: 3.94 mmHg, 95% CI: 1.86 to 6.01, P < 0.01, I2 = 33.5%, moderate certainty), and fasting blood glucose (WMD: −8.29 mg/dL, 95% CI: −15.19 to −1.39, P = 0.019, I2 = 43.7%, moderate certainty) levels; however, it had no significant effects on blood urea nitrogen, proteinuria, triglyceride, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and diastolic blood pressure levels. Conclusions Curcumin may provide great potential effects against DKD. More large-scale and high-quality RCTs are required to confirm these findings.
Highlights
Diabetic kidney disease (DKD), a common microvascular complication of diabetes, is characterized by increased albuminuria level or urinary albumin-to-creatinine ratio (UACR), decreased glomerular filtration rate (GFR), or both [1]
Two trials included patients with overt diabetic nephropathy [21, 22]; two trials were performed in patients with diabetic proteinuric chronic kidney disease [20, 23]; and one trial enrolled patients with diabetes requiring hemodialysis [19]
Our findings showed that supplemental curcumin, in comparison with placebo, significantly improved the serum creatinine (SCr), total cholesterol (TC), systolic blood pressure (SBP), and fasting blood glucose (FBG) levels in patients with DKD, with moderate certainty of evidence; it had no significant effects on the blood urea nitrogen (BUN), PRO, TG, high-density lipoprotein-cholesterol (HDL-C), lowdensity lipoprotein-cholesterol (LDL-C), and diastolic blood pressure (DBP) levels
Summary
Diabetic kidney disease (DKD), a common microvascular complication of diabetes, is characterized by increased albuminuria level or urinary albumin-to-creatinine ratio (UACR), decreased glomerular filtration rate (GFR), or both [1]. Sodium-glucose cotransporter 2 inhibitors, a new class of antidiabetic agents, have been shown to prevent major kidney outcomes in individuals with diabetes [3, 7]; close attention needs to be paid to their adverse effects [8]. These managements are effective, they do not seem to substantially decrease the morbidity of DKD and patients with this condition still have a high risk of disease progression [9], indicating the urgent need for complementary and alternative therapies.
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