Abstract
BackgroundIdiopathic membranous nephropathy (IMN) is one of the most common causes of nephrotic syndrome in adults involving multiple targets and factors. The effect of conservative nonimmunosuppressive or immunosuppressive therapies is unsatisfactory and with many side effects. Traditional Chinese medicine (TCM) can regulate immune function and improve kidney function.PurposeTo evaluate the total effective rate, curative rate, recurrence rate and adverse events of TCM alone or TCM as an adjunctive therapy for IMN.MethodsRandomized controlled trials (RCT) comparing either TCM alone or the combination of TCM to western medicine (WM) therapies for patients with IMN were retrieved by searching English and Chinese database. Risk of bias summary was used to assess the methodological quality of eligible studies. Dichotomous data were presented using odds ratios (OR). The primary outcome measure was the total effective rate. Secondary outcomes included curative rate, recurrence rate and adverse events.Results29 RCTs involving 1883 participants met the inclusion criteria. There was no statistically significant difference between the therapy of TCM alone and WM on the total effective rates (OR: 2.00; 95% CI: 0.80–4.98; P = 0.14) and curative rate (OR: 1.66; 95%CI: 0.66–4.22; p = 0.28). However, compared to basic treatment or immunosuppressive therapies alone, results showed that TCM as an adjunctive therapy had beneficial effects on the total effective rate (OR: 2.59; 95% CI: 1.38–4.86; P = 0.003 and OR: 3.01; 95% CI: 2.25–4.04; P < 0.00001) and curative rate (OR: 3.01; 95%CI: 1.24–7.28; p = 0.01 and OR: 1.73; 95%CI: 1.10–2.71; p = 0.02). In addition, the combination of TCM treatment could reduce the recurrence rate (OR: 0.28; 95% CI: 0.12–0.68; P = 0.004) and adverse reactions (OR: 0.38; 95% CI: 0.27–0.54; p < 0.00001).ConclusionThe results indicate that TCM is well-tolerated for the treatment of IMN. However, there remains a need for large-scale and high-quality trials.
Highlights
Membranous nephropathy (MN) is a common pathological type of adult nephrotic syndrome characterized by the deposition of immune complexes containing antigen, IgG, and complement on the subepithelial side of the glomerular basement membrane (GBM) [1]
There was no statistically significant difference between the therapy of Traditional Chinese medicine (TCM) alone and western medicine (WM) on the total effective rates (OR: 2.00; 95% confidence interval (CI): 0.80–4.98; P = 0.14) and curative rate (OR: 1.66; 95%CI: 0.66–4.22; p = 0.28)
Compared to basic treatment or immunosuppressive therapies alone, results showed that TCM as an adjunctive therapy had beneficial effects on the total effective rate
Summary
Membranous nephropathy (MN) is a common pathological type of adult nephrotic syndrome characterized by the deposition of immune complexes containing antigen, IgG, and complement on the subepithelial side of the glomerular basement membrane (GBM) [1]. Approximate 20%~30% of MN are secondary to systemic causes including infections, malignancy, autoimmune diseases or drugs and the remaining can be identified as idiopathic membranous nephropathy (IMN). It is an autoimmune disease correlated with antibodies against podocyte proteins and about 70% have been reported to be related to M-type phospholipase A2 receptor (PLA2R) [2]. Immunosuppressive therapy results in immune tolerance and the existence of multiple complications such as hyperlipidemia, infection, and thromboembolism, making it a major cause of refractory kidney disease. Idiopathic membranous nephropathy (IMN) is one of the most common causes of nephrotic syndrome in adults involving multiple targets and factors.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
