Alprostadil combined with tripterygium glycosides tablet in treatment of diabetic kidney disease: a systematic review and meta-analysis

摘要

Background:Diabetic kidney disease is now the principal cause of end-stage renal failure worldwide.Alprostadil combined with tripterygium glycosides tablet is a new method for diabetic kidney disease treatment.However,there are currently few systematic reviews on treatment for alprostadil combined with tripterygium glycosides tablet.Therefore,a systematic review and meta-analysis was conducted to analyze the function of alprostadil combined with tripterygium glycosides tablet in the treatment of diabetic kidney disease.Methods:We searched Pubmed,Embase,the Cochrane Library,Chinese databases,and clinical trial for randomized controlled trials of alprostadil combined with tripterygium glycosides tablet in the treatment of diabetic kidney disease,including results from the foundation of database until August 5,2020.Two reviewers have independently performed literature screening,data extraction,and quality evaluation.This meta-analysis has been carried out by RevMan5.4 software.Results:Ten randomized controlled trials with 724 patients were involved.Compared with alprostadil alone,the combination of alprostadil and tripterygium glycosides tablet in treatment of diabetic kidney disease could reduce the level of 24-hour urine protein(95%CI(–2.05,–0.22),P=0.01),serum creatinine(95%CI(–5.01,–0.20),P=0.03),level of interleukin-6(95%CI(−4.57,−2.37),P<0.00001),tumor necrosis factor-α(95%CI(−4.57,−2.37),P<0.00001).The combined treatment could also improve the clinical efficacy(95%CI(1.09,1.25),P<0.0001),and reduce the occurrence of serious adverse events(95%CI(0.26,0.94),P=0.03).However,there is no association of two treatments in blood urea nitrogen(95%CI(–4.17,2.11),P=0.52),albumin(95%CI(–1.10,0.97),P=0.90),triglyceride(95%CI(−1.44,1.50),P=0.97).Conclusion:Alprostadil combined with tripterygium glycosides tablet contributes to protecting renal function,inhibiting inflammation,and reducing the occurrence of adverse events,which could be considered as a feasible therapy for diabetic kidney disease patients.However,some clinical variables did not accurately conclude due to the low quality of methodology and small sample sizes.More rigorous and more extensive trials are essential to validate our results.Trial registration:Systematic review registration:(CRD42020203725).