Chinese herbal medicine for diabetic kidney disease: A systematic review and meta-analysis of randomised placebo-controlled trials

Zhang, L, Yang, L, Shergis, J, Zhang, L, Zhang, T, Guo, X, Qin, X, Johnson, D, Liu, X, Lu, C, Xue, C and Mao, W 2019, 'Chinese herbal medicine for diabetic kidney disease: A systematic review and meta-analysis of randomised placebo-controlled trials', BMJ Open, vol. 9, no. 4, pp. 1-13.


Document type: Journal Article
Collection: Journal Articles

Title Chinese herbal medicine for diabetic kidney disease: A systematic review and meta-analysis of randomised placebo-controlled trials
Author(s) Zhang, L
Yang, L
Shergis, J
Zhang, L
Zhang, T
Guo, X
Qin, X
Johnson, D
Liu, X
Lu, C
Xue, C
Mao, W
Year 2019
Journal name BMJ Open
Volume number 9
Issue number 4
Start page 1
End page 13
Total pages 13
Publisher BMJ Group
Abstract Objectives To provide a broad evaluation of the efficacy and safety of oral Chinese herbal medicine (CHM) as an adjunctive treatment for diabetic kidney disease (DKD), including mortality, progression to end-stage kidney disease (ESKD), albuminuria, proteinuria and kidney function. Design A systematic review and meta-analysis. Methods Randomised controlled trials (RCTs) comparing oral CHM with placebo as an additional intervention to conventional treatments were retrieved from five English (Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Allied and Complementary Medicine Database and Cumulative Index of Nursing and Allied Health Literature) and four Chinese databases (China BioMedical Literature, China National Knowledge Infrastructure, Chonqing VIP and Wanfang) from inception to May 2018. RCTs recruiting adult DKD patients induced by primary diabetes were considered eligible, regardless of the form and ingredients of oral CHM. Mean difference (MD) or standardised mean difference (SMD) was used to analyse continuous variables and RR for dichotomous data. Results From 7255 reports retrieved, 20 eligible studies involving 2719 DKD patients were included. CHM was associated with greater reduction of albuminuria than placebo, regardless of whether renin-angiotensin system (RAS) inhibitors were concurrently administered (SMD -0.56, 95% CI [-1.04 to -0.08], I 2 =64%, p=0.002) or not (SMD -0.92, 95% CI [-1.35 to -0.51], I 2 =87%, p<0.0001). When CHM was used as an adjunct to RAS inhibitors, estimated glomerular filtration rate was higher in the CHM than placebo group (MD 6.28 mL/min; 95% CI [2.42 to 10.14], I 2 =0%, p=0.001). The effects of CHM on progression to ESKD and mortality were uncertain due to low event rates. The reported adverse events in CHM group included digestive disorders, elevated liver enzyme level, infection, anaemia, hypertension and subarachnoid haemorrhage, but the report rates were low and similar to control groups. The favourable re
Subject Traditional Chinese Medicine and Treatments
Keyword(s) Chinese herbal medicine
complementary and alternative medicine
diabetic kidney disease
meta-analysis
systematic review
DOI - identifier 10.1136/bmjopen-2018-025653
Copyright notice © 2019 Author(s) (or their employer(s)) 2019. Re-use permitted under Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license
ISSN 2044-6055
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