Topical herbal application as an adjuvant treatment for chronic kidney disease--a systematic review of randomized controlled clinical trials.
OBJECTIVE
To report a systematic review to evaluate whether topical herbal medicine delays the progress of renal disease and improves its complications in people with chronic kidney disease.


BACKGROUND
Besides dialysis or renal transplantation, patients with chronic kidney disease, especially those with insufficient renal function, are in a great need of effective conservative treatment methods. Topical application of herbal medicine, a common treatment modality in China, has been found in some clinical studies to benefit the patients with chronic kidney disease.


METHODS
The English databases including CENTRAL (February 2010), Medline (1950 to February 2010), EMBASE (1980 to February 2010), and AMED (1985 to January 2010), and several Chinese databases covering the period of 1949 to February 2010 were searched for randomized controlled trials that compared external use of herbal medicine with no treatment, placebo, or conventional treatment for chronic kidney disease and its complications.


METHODS
We undertook a systematic review and meta-analysis following Cochrane processes.


RESULTS
Twenty-three trials with a total of 1057 patients were included. Their results suggest that herbal paste and bathing or fuming treatment might have a beneficial effect in terms of delaying the progress of renal disease, improving kidney function, and ameliorating some kidney complications in patients with chronic kidney disease. However, the low quality and poor reporting practices of the studies covered led to no definitive conclusion.


CONCLUSIONS
Further larger and more rigorously designed clinical trials with proper outcome measures are needed to confirm the findings.
School of Chinese Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.
Hongwei
H
Zhang
Yi Fong
YF
Ho
Chun-Tao
CT
Che
Zhi-Xiu
ZX
Lin
Connie
C
Leung
Lai Sum
LS
Chan
D000287:Administration, Topical; D001494:Baths; D002681:China; D018450:Disease Progression; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods*; D015399:Nursing Research; D010919:Placebos; D016032:Randomized Controlled Trials as Topic; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000503:physiopathology
D004365:Drugs, Chinese Herbal; D010919:Placebos