• Daijin Ren, Chao Zuo, and Gaosi Xu.
• Department of Nephrology, the Second Affiliated Hospital of Nanchang University.
• Medicine (Baltimore). 2019 Mar 1; 98 (11): e14604e14604.

BackgroundThe present study aims to evaluate the clinical efficacy and safety of Tripterygium wilfordii Hook (TwH) combined with angiotensin receptor blockers/ACE inhibitors (ARB/ACEI) in the treatment of diabetic kidney disease (DKD) stage IV.MethodsWe searched China National Knowledge Internet (CNKI), the Chinese Biomedical Database, Embase and PubMed for articles about TwH combined with ARB/ACEI in treating DKD stage IV and set the study inclusion and elimination standards.ResultsA total of 22 randomized controlled trials (RCTs) with 1414 participants were collected for detailed evaluation. The meta-analysis results suggested that compared with the controls, the combined group showed significant effects in reducing 24-h urinary protein [mean difference (MD) = -0.87, 95% confidence interval (CI) = (-1.03, -0.71)], raising serum albumin [MD = 4.14, 95% CI (3.43, 4.85)] and the total efficiency [odds ratio (OR) = 4.84, 95% CI (3.33, 7.03)], with no statistical difference in serum creatinine between both groups [MD = -3.02, 95% CI (-6.40, 0.37), P > .05]. However, the risk of adverse reactions increased by 8% [Risk Difference (RD) = 0.08, 95% CI (0.05, 0.11)] in the combination.ConclusionsTwH combined with ARB/ACEI in the treatment of DKD stage IV is superior to the monotherapy of ARB/ACEI.

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