title: The therapeutic effect and possible harm of puerarin for treatment of stage III diabetic nephropathy: a meta-analysis.
abstract: BACKGROUND
  Diabetic nephropathy (DN) is the main cause of end-stage kidney disease in developed countries. Current therapy can slow the rate of progression of DN, but eventually end-stage renal failure will occur in a proportion of patients. Identification of new strategies and additional complementary and alternative therapies for treating DN are important.
  
  
  OBJECTIVE
  The research team wanted to assess the beneficial and harmful effects of using puerarin plus angiotensin converting enzyme inhibitor (ACEI) compared with using only ACEI for treatment of individuals with stage III DN.
  
  
  METHODS
  The research team performed a meta-analysis of randomized, controlled trials (RCTs) by searching the following electronic databases: (1) the Cochrane Database of Systematic Reviews, (2) the Cochrane Central Register of Controlled Trials (CENTRAL), (3) PubMed, (4) EMBASE (Elsevier), (5) the Allied and Complementary Medicine Database (AMED), (6) the Chinese Biomedicine Database (CBM), (7) the China National Knowledge Infrastructure (CNKI), and (8) the Chinese Biomedical Journals (VIP), with no language restrictions, as well as databases of clinical trials.
  
  
  METHODS
  Measured outcomes included (1) urinary protein measured as urinary albumin excretion rate (UAER) (μg/min) and 24-h urine protein (24-h UP) (mg/24 h); (2) renal function measured as blood urea nitrogen (BUN) (mmol/L) and serum creatinine (SCr) (μmol/L); (3) α1-microglobulin (α1-MG) (mg/24 h) and endothelin-1 (ET-1) (ng/24 h); (4) end points (EPs); and (5) adverse events (AEs).
  
  
  RESULTS
  Ten RCTs involving 669 participants were included. All trials were conducted and published in China. Treatment of DN with puerarin plus ACEI significantly decreased the UAER-P < .0001, MD = -23.43 (95% CI, -33.95 to -12.91), and had no effect on 24-h UP-P = .09, MD = -56.76 (95% CI, -122.65 to 9.12); BUN-P = .17, MD = -0.51 (95% CI, -1.24 to 0.21); and SCr-P = .26, MD = -4.43 (95% CI, -12.05 to 3.20). One trial reported abdominal discomfort and nausea (2 cases) in the treatment group.
  
  
  CONCLUSIONS
  Puerarin may be a beneficial therapy for treating DN; however, this hypothesis needs to be proven by additional high-quality studies using large samples and multicenter evidence.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.forename: Shibo
authors.initials: S
authors.lastname: Chen
authors.forename: Xiufeng
authors.initials: X
authors.lastname: Yan
authors.forename: Mingdi
authors.initials: M
authors.lastname: Li
authors.forename: Daqi
authors.initials: D
authors.lastname: Li
authors.forename: Pin
authors.initials: P
authors.lastname: Lv
authors.forename: Guixiang
authors.initials: G
authors.lastname: Ti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D007529:Isoflavones / Q000009:adverse effects* / Q000627:therapeutic use*; D008875:Middle Aged; D014665:Vasodilator Agents / Q000009:adverse effects* / Q000627:therapeutic use*
chemical_list: D007529:Isoflavones; D014665:Vasodilator Agents; D003404:Creatinine; C033607:puerarin