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

2018 ◽  
Vol 40 (4) ◽  
pp. 375-387 ◽  
Author(s):  
Camila Marques Oliveira ◽  
Caroline Pereira Domingueti

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.

PLoS ONE ◽  
2017 ◽  
Vol 12 (6) ◽  
pp. e0178699 ◽  
Author(s):  
Davide Bolignano ◽  
Valeria Cernaro ◽  
Guido Gembillo ◽  
Rossella Baggetta ◽  
Michele Buemi ◽  
...  

SLEEP ◽  
2016 ◽  
Vol 39 (2) ◽  
pp. 301-308 ◽  
Author(s):  
Wen Bun Leong ◽  
Ferozkhan Jadhakhan ◽  
Shahrad Taheri ◽  
G. Neil Thomas ◽  
Peymané Adab

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Zhao Jie ◽  
Mo Chao ◽  
Ai Jun ◽  
Shi Wei ◽  
Meng LiFeng

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.


Author(s):  
LaTonya J. Hickson ◽  
Tala Abedalqader ◽  
Gift Ben‐Bernard ◽  
Jayla M. Mondy ◽  
Xiaohui Bian ◽  
...  

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Wenshan Lin ◽  
Hong-Yan Li ◽  
Qian Yang ◽  
Guangyong Chen ◽  
Shujun Lin ◽  
...  

Abstract Background Mesenchymal stem cell (MSC) therapy shows great promise for diabetic kidney disease (DKD) patients. Research has been carried out on this topic in recent years. The main goals of this paper are to evaluate the therapeutic effects of MSCs on DKD through a meta-analysis and address the mechanism through a systematic review of the literature. Method An electronic search of the Embase, Cochrane Library, ISI Web of Science, PubMed, and US National Library of Medicine (NLM) databases was performed for all articles about MSC therapy for DKD, without species limitations, up to January 2020. Data were pooled for analysis with Stata SE 12. Result The MSC-treated group showed a large and statistically significant hypoglycemic effect at 1 week, 2 weeks, 3 weeks, 1 month, 2 months, 3 months, and 6 months. Total hypoglycemic effect was observed (SMD = − 1.954, 95%CI − 2.389 to − 1.519, p < 0.001; I2 = 85.1%). The overall effects on serum creatinine (SCr) and blood urea nitrogen (BUN) were analyzed, suggesting that MSC decreased SCr and BUN and mitigated the impairment of renal function (SCr: SMD = − 4.838, 95%CI − 6.789 to − 2.887, p < 0.001; I2 = 90.8%; BUN: SMD = − 4.912, 95%CI − 6.402 to − 3.422, p < 0.001; I2 = 89.3%). Furthermore, MSC therapy decreased the excretion of urinary albumin. Fibrosis indicators were assessed, and the results showed that transforming growth factor-β, collagen I, fibronectin, and α-smooth muscle actin were significantly decreased in the MSC-treated group compared to the control group. Conclusion MSCs might improve glycemic control and reduce SCr, BUN, and urinary protein. MSCs can also alleviate renal fibrosis. MSC therapy might be a potential treatment for DKD.


2020 ◽  
Author(s):  
Wenshan Lin ◽  
Qian Yang ◽  
Guangyong Chen ◽  
Shujun Lin ◽  
Chunling Liao ◽  
...  

Abstract Background: Mesenchymal stem cell (MSC) therapy shows great promise for diabetic kidney disease (DKD) patients. Research has been carried out on this topic in recent years. The main goal of this paper is to evaluate the therapeutic effects of MSCs on DKD through a meta-analysis and address the mechanism through a systematic review of the literature.Method: An electronic search of the Embase, Cochrane Library, ISI Web of Science, PubMed and U.S National Library of Medicine (NLM) databases was performed for all articles about MSC therapy for DKD, without species limitations, up to January 2020. Data were pooled for analysis with Stata SE 12.Result: The MSC-treated group showed a large and statistically significant hypoglycemic effect at 1 week, 2 weeks, 3 weeks, 1 month, 2 months, 3 months and 6 months. Total hypoglycemic effect was observed (SMD=-1.954, 95%CI: -2.389 to -1.519, p<0.001). The overall effects on serum creatinine (SCr) and blood urea nitrogen (BUN) were analyzed, suggesting that MSC decreased SCr and BUN and mitigated the impairment of renal function (SCr: SMD= -4.838, 95%CI: -6.789 to -2.887, p<0.001; BUN: SMD= -4.912, 95%CI: -6.402 to -3.422, p<0.001). Furthermore, MSC therapy decreased the excretion of urinary albumin. Fibrosis indicators were assessed, and the results showed that transforming growth factor-β, collagen-I, fibronectin and α-smooth muscle actin were significantly decreased in the MSC-treated group compared to the control group.Conclusion: MSCs may improve glycemic control and reduce SCr, BUN, and urinary protein. MSCs can also alleviate renal fibrosis. MSC therapy is a potential treatment for DKD.


2021 ◽  
Author(s):  
Jingxin Zhou ◽  
Wenhua Zhang ◽  
Jie Yang ◽  
Qiaoqiao Liu ◽  
Yizhen Lu ◽  
...  

Abstract Background: Diabetic kidney disease (DKD), which is a serious complication of diabetes and the leading cause of end-stage renal disease, becomes a major health concern worldwide. Keluoxin capsule, a Chinese patent medicine used for DKD, has been widely used in diabetic kidney disease, but its efficacy and safety have not yet been clarified. Therefore, the aim of this systematic review and meta-analysis is to summarize the efficacy and safety of Keluoxin capsule in the treatment of DKD. Methods: A systematic literature search will be conducted in PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, WANFANG database, VIP, SinoMED, and Chinese Biomedical Literature Database (CBM) to ensure all possible randomized controlled trials (RCT) studies on K eluoxin capsule to November 1, 2021. The primary outcome to be assessed will include the change in albuminuria and estimated glomerular filtration rate (eGFR), while secondary outcomes will be serum creatinine, blood urea nitrogen, glycated hemoglobin, total cholesterol, low-density lipoprotein cholesterol, and triglycerides, etc and adverse events. The quality of the included studies and the risk of bias will be independently assessed by two reviewers using the risk of bias assessment tool from Cochrane Handbook. We will conduct random-effects model meta-analysis using Review Manager software (Revman5.3). Discussion: This systematic review and meta-analysis will objectively evaluate the effect of Keluoxin capsule for DKD, and provide evidence for Keluoxin capsule in the treatment of DKD. Ethics and dissemination : Ethics approval is not required for this study. We aim to publish the results of this systematic review in a peer-reviewed journal. INPLASY registration number: INPLASY 2021110067.


2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Yu-meng Tan ◽  
Jun Hu ◽  
Qian Wu ◽  
Yi Zhang ◽  
Wen-dong Suo ◽  
...  

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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