Antioxidant agents for delaying diabetic kidney disease progression: A systematic review and meta-analysis

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.

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Major Advancements in Slowing Diabetic Kidney Disease Progression: Focus on SGLT2 Inhibitors

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2019.05.009 ◽

2019 ◽

Vol 74 (5) ◽

pp. 573-575 ◽

Cited By ~ 12

Author(s):

George L. Bakris

Keyword(s):

Kidney Disease ◽

Disease Progression ◽

Diabetic Kidney Disease ◽

Sglt2 Inhibitors ◽

Diabetic Kidney ◽

Kidney Disease Progression

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Addition of Metabolic Syndrome to Albuminuria Provides a New Risk Stratification Model for Diabetic Kidney Disease Progression in Elderly Patients

Scientific Reports ◽

10.1038/s41598-020-63967-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Hong-Mou Shih ◽

Shih-Ming Chuang ◽

Chun-Chuan Lee ◽

Sung-Chen Liu ◽

Ming-Chieh Tsai

Keyword(s):

Metabolic Syndrome ◽

Kidney Disease ◽

Risk Stratification ◽

Elderly Patients ◽

Disease Progression ◽

Diabetic Kidney Disease ◽

Diabetic Kidney ◽

Risk Stratification Model ◽

Kidney Disease Progression

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Association of Body Mass Index with Clinical Outcomes in Non-Dialysis-Dependent Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Cardiorenal Medicine ◽

10.1159/000437277 ◽

2015 ◽

Vol 6 (1) ◽

pp. 37-49 ◽

Cited By ~ 52

Author(s):

Seyed-Foad Ahmadi ◽

Golara Zahmatkesh ◽

Emad Ahmadi ◽

Elani Streja ◽

Connie M. Rhee ◽

...

Keyword(s):

Systematic Review ◽

Body Mass Index ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Disease Progression ◽

Body Mass ◽

Meta Analysis ◽

Risk Of Death ◽

Kidney Disease Progression ◽

Meta Analyses

Background: Previous studies have not shown a consistent link between body mass index (BMI) and outcomes such as mortality and kidney disease progression in non-dialysis-dependent chronic kidney disease (CKD) patients. Therefore, we aimed to complete a systematic review and meta-analysis study on this subject. Methods: We searched MEDLINE, EMBASE, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Central Register of Controlled Trials (CENTRAL), and screened 7,123 retrieved studies for inclusion. Two investigators independently selected the studies using predefined criteria and assessed each study's quality using the Newcastle-Ottawa quality assessment scale. We meta-analyzed the results based on the BMI classification system by the WHO. Results: We included 10 studies (with a total sample size of 484,906) in the systematic review and 4 studies in the meta-analyses. The study results were generally heterogeneous. However, following reanalysis of the largest reported study and our meta-analyses, we observed that in stage 3-5 CKD, being underweight was associated with a higher risk of death while being overweight or obese class I was associated with a lower risk of death; however, obesity classes II and III were not associated with risk of death. In addition, reanalysis of the largest available study showed that a higher BMI was associated with an incrementally higher risk of kidney disease progression; however, this association was attenuated in our pooled results. For earlier stages of CKD, we could not complete meta-analyses as the studies were sparse and had heterogeneous BMI classifications and/or referent BMI groups. Conclusion: Among the group of patients with stage 3-5 CKD, we found a differential association between obesity classes I-III and mortality compared to the general population, indicating an obesity paradox in the CKD population.

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