Abstract
BackgroundsDiabetic nephropathy (DN) is one of the most important clinical complications of diabetes mellitus (DM) and is the most common cause of end-stage renal disease. Currently, there is no highly effective medicine that can prevent, halt, or reverse the progressive course of DN. Initial clinical data showed that Tripterygium glycosides (TGs), a traditional Chinese medicine, can decrease proteinuria in patients with DN.ObjectivesThe objective of the present study is to investigate the efficacy and safety of TGs for the treatment of DN through meta-analysis of randomized controlled trials (RCTs).MethodsAll RCTs of TGs for DN were collected from The China National Knowledge Infrastructure (CNKI), PubMed, Web of Science, Wanfang Data, Chinese Biomedical Literature Database (CBM), China Science and Technology Journal Database (VIP) by setting the study inclusion and elimination standards. Two reviewers evaluated the quality of the trials and extracted the data independently. RevMan 5.4 software was used for meta-analyses. The primary outcome was a change in 24-hours urinary total protein (24 h TUP).Results26 RCTs with 1824 participants were identified. Studies were assessed using the Cochrane risk of bias tool. The overall effects showed that TGs was compared with the controls, TGs showed significant effects in reducing 24 h TUP [WMD = -0.84, 95 % CI (-1.09, -0.59)], elevating serum albumin [WMD = 2.88, 95 % CI (1.87, 3.90)], and the total efficiency [OR = 4.08, 95 % CI (2.37, 7.04)]. This effect was consistent across the subgroups of period of intervention.ConclusionsThe present research showed that TGs was significantly associated with improvement of renal function in patients with DN. TGs offers a novel approach to the treatment of DN, more high-quality RCTs are needed for a better understanding of the role of TGs in DN therapy.
Highlights
Diabetic nephropathy (DN) is one of the most important clinical complications of diabetes mellitus (DM), recently named diabetic kidney disease (DKD), and is the most common cause of chronic kidney diseases [1]
The overall effects showed that Tripterygium glycosides (TGs) was compared with the controls, TGs showed significant effects in reducing 24 h 24-hours urinary total protein (TUP) [WMD = -0.84, 95 % confidence intervals (CI) (-1.09, -0.59)], elevating serum albumin [WMD = 2.88, 95 % CI (1.87, 3.90)], and the total efficiency [Odds ratio (OR) = 4.08, 95 % CI (2.37, 7.04)]
TGs offers a novel approach to the treatment of DN, more high-quality randomized controlled trials (RCTs) are needed for a better understanding of the role of TGs in DN therapy
Summary
Diabetic nephropathy (DN) is one of the most important clinical complications of diabetes mellitus (DM), recently named diabetic kidney disease (DKD), and is the most common cause of chronic kidney diseases [1]. The studies were from more recent years show that inflammation played a vital role in the pathogenesis of DN [7]. How to select new drugs for diabetic nephropathy from the perspective of anti-inflammatory and immunosuppressive is a subject for kidney disease workers. In 1977, Chinese scholars first reported its role in reducing proteinuria in glomerulonephritis, and TGs began to be used in the clinical treatment of renal diseases. TGs have been extensively used in China for the treatment of autoimmune diseases, such as rheumatoid arthritis, primary glomerulonephritis, and immune-related nephritis [11,12,13]. Some clinical studies apply TGs in the treatment of DN, It is suggested that TGs can antagonize the anti-inflammatory effect on the pathogenesis of DN and protect renal function [14]. This study systematically evaluated the efficacy and safety of TGs in the treatment of DN on the basis of existing RCTs, Aimed at providing evidencebased medical evidence for the clinical application of TGs in the treatment of DN
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