Fufang Xueshuantong for Diabetic Kidney Disease: A Systematic Review and Meta-Analysis

Objective. The objective of this meta-analysis was to systematically assess the efficacy and safety of patented Chinese medicine Fufang Xueshuantong (FFXST) for the treatment of diabetic kidney disease (DKD). Methods. Randomized controlled trials (RCTs) of FFXST for DKD treatment were searched until May 31, 2020, in seven electronic databases: PubMed, Embase, Cochrane Library, CNKI, Wanfang, VIP, and Chinese Biomedical Literature. The Cochrane risk test from the Cochrane Handbook was used as a bias tool to assess the methodological quality, and Review Manager (RevMan) 5.3 was used to analyze the results. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria were used to classify the quality of evidence. Results. Thirteen RCTs involving 1,186 patients were included. The meta-analysis revealed that the efficacy of FFXST in treatment of DKD was significantly superior to that of the control treatment ( P = 0. 0006 ). The urinary albumin excretion rate ( P < 0.01 ), urinary albumin creatinine ratio ( P < 0.0001 ), and microalbumin ( P < 0.0001 ) were lower in the treatment groups than in the control group. There was also a decrease in low-density lipoprotein cholesterol ( P < 0.0001 ), serum triglyceride ( P = 0.001 ), and C-reactive protein ( P < 0.0001 ) in the treatment groups compared with those in the control group. No significant difference in hemoglobin A1c level ( P = 0.76 ) and systolic blood pressure ( P = 0.34 ) was noted between the treatment and control groups. Three studies reported adverse events, including dizziness and intolerance. In the other 10 trials, adverse events were not mentioned. Conclusion. FFXST appears to be effective in the treatment of DKD. However, the low methodological quality of the RCTs suggests that larger, better-designed RCTs are required to verify the clinical eﬀectiveness and safety of FFXST.

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The role of C-peptide in the attenuation of outcomes of diabetic kidney disease: a systematic review and meta-analysis

Brazilian Journal of Nephrology ◽

10.1590/2175-8239-jbn-2017-0027 ◽

2018 ◽

Vol 40 (4) ◽

pp. 375-387 ◽

Cited By ~ 1

Author(s):

Camila Marques Oliveira ◽

Caroline Pereira Domingueti

Keyword(s):

Systematic Review ◽

Kidney Disease ◽

Glomerular Filtration ◽

Diabetic Kidney Disease ◽

Meta Analysis ◽

Control Group ◽

C Peptide ◽

Diabetic Kidney ◽

Preclinical Trials ◽

Urine Potassium

ABSTRACT Introduction: Preclinical trials have shown that C-peptide may contribute to the treatment of diabetic kidney disease (DKD). This systematic review and meta-analysis aimed to assess the use of C-peptide in attenuating the outcomes of DKD. Methods: Searches were made on databases PubMed, Web of Science, and Scielo for in vivo clinical and preclinical trials written in English, Portuguese or Spanish that looked into the use of C-peptide in the attenuation of the outcomes of DKD. Results: Twelve papers were included in this review, one clinical and eleven preclinical trials. In the clinical trial, DKD patients given C-peptide had lower levels of albuminuria than the subjects in the control group, but glomerular filtration rates were not significantly different. The main parameters assessed in the preclinical trials were glomerular filtration rate (six trials) and albuminuria (five trials); three trials described less hyperfiltration and three reported lower levels of albuminuria in the groups offered C-peptide. The meta-analysis revealed that the animals given C-peptide had lower glomerular volumes and lower urine potassium levels than the groups not given C-peptide. Conclusion: The results of the studies included in the systematic review diverged. However, the meta-analysis showed that the animals given C-peptide had lower glomerular volumes and lower urine potassium levels.

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Meta-analysis of the efficacy and safety of finerenone in diabetic kidney disease

Kidney & Blood Pressure Research ◽

10.1159/000521908 ◽

2022 ◽

Author(s):

Yaning Zheng ◽

Sheng Ma ◽

Qiaomu Huang ◽

Yu Fang ◽

Hongjin Tan ◽

...

Keyword(s):

Renal Function ◽

Placebo Group ◽

Kidney Disease ◽

Adverse Events ◽

Diabetic Kidney Disease ◽

Meta Analysis ◽

Phase Iii ◽

Cochrane Library ◽

Efficacy And Safety ◽

Diabetic Kidney

Background: The Phase III clinical trial of the non-steroidal mineralocorticoid receptor antagonist finerenone (BAY 94-8862) has been completed, aiming to investigate renal and cardiovascular (CV) outcomes in type 2 diabetes (T2D) with chronic kidney disease (CKD). However, the efficacy and safety of finerenone in renal function remain controversial. The purpose of this study was to explore the efficacy and safety of finerenone in treating the patients with diabetic kidney disease (DKD). Methods: Databases of PubMed, Cochrane Library, Embase, and Web of Science were searched for randomized controlled trials (RCTs) on patients with DKD receiving finerenone treatment from inception to September 2021. Data including patient characteristics and interested outcomes were extracted, and the dichotomous data and continuous variables were evaluated using risk ratio (RR) with 95% confidence intervals (CIs) and mean differences (MD) with 95% CIs, respectively. Results: A total of 4 RCTs involving 13945 patients were included in this meta-analysis. Analysis results demonstrated that patients receiving finerenone showed a significant decrease in changing urinary albumin-to-creatinine ratio (UACR) from baseline (MD: ﹣0.30; 95%CI [﹣0.33, ﹣0.27] P=0.46, I2=0%) (P＜0.05). The number of patients with ≥40% reduction in estimated glomerular filtration rate (eGFR) from baseline in the finerenone group was significantly smaller than that in the placebo group (RR: 0.85; 95%CI [0.78, 0.93] P=0.60, I2=0%) (P＜0.05). No difference was found in adverse events between the finerenone and placebo groups (RR: 1.00; 95%CI [0.98, 1.01] P = 0.94, I2=0%) (P=0.65). The incidence of hyperkalemia was higher in the finerenone group than that in the placebo group (RR: 2.03; 95%CI [1.83, 2.26] P = 0.95, I2=0%) (P＜0.05). Conclusion: Finerenone contributes to the reduction of UACR and can ameliorate the deterioration of renal function in patients with T2D and CKD. The higher risk of hyperkalemia was found in the finerenone group compared with placebo, however, there was no difference in the risk of overall adverse events.

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Quality of evidence supporting the role of YiQi-HuoXue method for the treatment of diabetic kidney disease: A protocol for an overview of systematic review and meta-analysis

10.37766/inplasy2022.1.0024 ◽

2022 ◽

Author(s):

Hongshuo Shi ◽

◽

Lina Lv ◽

Yinghao Li ◽

Min Peng ◽

...

Keyword(s):

Systematic Review ◽

Kidney Disease ◽

Diabetic Kidney Disease ◽

Meta Analysis ◽

Diabetic Kidney ◽

Quality Of Evidence

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Efficacy and Safety of “Bushen Huoxue Therapy”-Based Combined Chinese and Western Medicine Treatment for Diabetic Kidney Disease: an Updated Meta-Analysis of 2105 Patients

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2022/3710074 ◽

2022 ◽

Vol 2022 ◽

pp. 1-12

Author(s):

Hongdian Li ◽

Shaoning Dong ◽

Yashen Liu ◽

Ni Tian ◽

Wenxue Yang ◽

...

Keyword(s):

Chinese Medicine ◽

Kidney Disease ◽

Western Medicine ◽

Diabetic Kidney Disease ◽

Meta Analysis ◽

Cochrane Library ◽

Control Group ◽

Efficacy And Safety ◽

Diabetic Kidney ◽

Experimental Group

Background. Diabetic kidney disease (DKD) is the most important cause of the end-stage renal disease (ESRD) and the main cause of renal replacement therapy. Excessive inflammatory response and renal fibrosis are the keys to the development of this disease, and the conventional Western medical treatment is difficult to achieve and obtain long-term stable clinical results in all patients with DKD. Many studies have shown that Chinese medicine as a complementary and alternative medicine may be another therapeutic option to mitigate the progression of DKD to ESRD. In recent years, many doctors have used the Bushen Huoxue therapy to assist Western medicine in the treatment of the disease and have achieved certain clinical effects. However, most of the current studies are small sample studies, and there is no evidence-based confirmation. Objective. To systematically evaluate the efficacy and safety of the Bushen Huoxue therapy combined with conventional Western medicine in the treatment of DKD. Methods. A comprehensive search of literature databases such as CNKI, Wanfang, Pubmed, and Cochrane Library was conducted. The screening condition was that the control group was treated with conventional Western medicine and the experimental group was treated with Bushen Huoxue therapy’s RCT on top of the control group, and the RCTs were published from January 2011 to October 2021. The Cochrane risk bias assessment tool was used for literature quality evaluation, and RevMan 5.3 software was used for statistical analysis. Results. A total of 23 RCTs were finally included, with a total of 2,105 patients. Meta-analysis results show that the experimental group can effectively improve the clinical efficacy (RR = 1.28, 95% CI (1.22, 1.34), P < 0.01 ), significantly reduce Crea (SMD = −0.45, 95% CI (−0.57, −0.33), P < 0.01 ), 24 h UTP (SMD = −0.57, 95% CI (−0.69, −0.45), P < 0.01 ), BUN (SMD = −0.36, 95%CI (−0.48, −0.24), P < 0.01 ), UAER (SMD = −1.58, 95% CI (−1.78, −1.37), P < 0.01 ), and blood sugar, and have certain medication safety (RR = 0.00, 95% CI (−0.03, 0.03), P = 0.87 ). Conclusions. Chinese medicine based on the Bushen Huoxue therapy has a good clinical effect in the treatment of diabetic kidney disease and has certain safety. However, due to the limitation of the quality and quantity of the included literature, the above conclusion still needs more rational experiments to further verify.

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