Shenkang injection in the treatment of diabetic nephropathy at stage Ⅲ: A systematic review and meta-analysis

Objective To systematically evaluate the clinical effectiveness and safety of Shenkang injection (SKI) in the treatment of diabetic nephropathy (DN) at stage Ⅲ. Methods Seven English and Chinese databases (up to Mar. 25, 2018), were searched to collect the clinical researches on SKI for DN stage III. Two researchers independently screened the literatures and evaluated the quality of the literatures according to the Cochrane Reviewer's Handbook 5.1. Stata 14.0 was used for the meta-analysis. Results In terms of effectiveness, a total of 10 studies involving 686 patients were included. The meta-analysis results showed that compared with the control group, the experimental group with SKI performed better in reducing the urinary albumin excretion rateSMD=-1.29, 95%CI(-1.77,-0.80), P<0.05, serum creatinineSMD=-0.86, 95%CI(-1.54,-0.18), P<0.05, cystatin cSMD=-1.87, 95%CI(-2.40,-1.34), P<0.05, with no statistically significant difference in the quantitative test of 24-h urinary proteinSMD=-4.75, 95%CI(-10.50,1.00), P>0.05 and blood urea nitrogenSMD=-0.01, 95%CI(-0.39,0.38), P>0.05 between two groups. In terms of safety, 7 studies were included, and no serious adverse events/adverse events (ADR/AE) were found. Conclusions The meta-analysis results showed that SKI for DN stage Ⅲ treatment could reduce the urinary albumin excretion rate and improve renal function. However, due to the limited number and quality of studies included in this meta-analysis, the above conclusions still need to be confirmed by more high-quality, large-sample, multi-center clinical studies. Although the systematic evaluation has not yet found the severe ADR/AE in the treatment of DN stage Ⅲ by SKI, the safety assessment of SKI for clinical use still needs to be emphasized and carried out.