Abstract
Objective To systematically evaluate the efficacy and safety of tanshinone for chronic kidney disease (CKD). Methods Randomized controlled trials (RCTs) on the treatment of CKD using tanshinone were searched using 4 Chinese databases (China National Knowledge Infrastructure (CNKI), Value In Paper (VIP), Wanfang, and Chinese Biology Medicine (CBM)) and 3 English databases (PubMed, Cochrane Library, and Excerpta Medica Database (Embase)). The results included data on blood urine nitrogen (BUN), serum creatinine (Scr), glomerular filtration rate (GFR), 24 h urine protein, microalbuminuria (mALB), β2-macroglobulin (β2-MG), cystatin C (CysC), and safety events. The data were analyzed using Revman 5.3 and Stata 12.0 software. Results Twenty-one studies were entered into this meta-analysis, which involved 1857 patients including 954 cases from the tanshinone treatment group and 903 cases from the control group. BUN levels in the tanshinone treatment group were significantly reduced compared with the control (standardized mean difference (SMD) = −0.65, 95% confidence interval (CI): −0.81 to −0.49, p < 0.01). In addition, subgroup analysis indicated that tanshinone had a significant effect in reducing Scr levels at 14, 21, and 28 days. Scr levels in the tanshinone treatment group were significantly reduced compared with the control group (SMD = −1.40, 95% CI: −2.09 to −0.71, p < 0.01); subgroup analysis based on treatment time also yielded the same results. GFR in the tanshinone treatment group was better than that in the control group (SMD = 0.83, 95% CI: 0.59 to 1.07, p < 0.01). In terms of urine protein levels, 24 h urine protein level, mALB, and β2-MG of CKD patients were reduced to some degree compared with controls, and CysC levels in the tanshinone treatment group were also significantly reduced compared with the control group (SMD = −0.24, 95% CI: −0.44 to −0.03, p < 0.05). Safety in the tanshinone treatment group did not differ significantly from that of the control group (risk ratio (RR) = 7.78, 95% CI: 0.99 to 61.05, p > 0.05). Conclusion This meta-analysis showed that tanshinone could control urine protein level in CKD patients, improve kidney function, and delay the evolution of CKD without significant side effects. However, the results were limited and should be interpreted with caution because of the low quality of the included studies. In the future, more rigorous clinical trials need to be conducted to provide sufficient and accurate evidence.
Highlights
Chronic kidney disease (CKD) is a condition of functional and structural dysfunction of the kidney with impairment longer than 3 months, caused by various factors
Hormone and immune suppressors are only effective in part of the pathogenesis of kidney injury and lead to high rates of relapse. eir long-term application can lead to severe infection and osteonecrosis of the femoral head, among other side effects [3, 4]. erefore, safe and efficacious drugs are needed for CKD treatment
Criteria for Literature Exclusion. e exclusion criteria for literature were as follows: (1) cases not definitively diagnosed with CKD, (2) repeatedly published articles, (3) too little information reported to be useful, and (4) the number of cases and treatments not accurately provided
Summary
Chronic kidney disease (CKD) is a condition of functional and structural dysfunction of the kidney with impairment longer than 3 months, caused by various factors It is characterized by normal or abnormal glomerular filtration rate (GFR) from pathological glomerular injury, abnormal renal function indices in urine or blood, abnormal imaging findings, or decreased GFR for more than 3 months of unknown etiology (
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