02552nas a2200217   4500000000100000008004100001100001600042700001100058700001400069700001200083700001200095700001200107700001100119700001500130700001400145700001900159245009400178250001500272520200100287020004602288       2013                            d1 aLiyanage T.1 aZhu B.1 aCass Alan1 aChen H.1 aWang Y.1 aWang A.1 aJun M.1 aJicheng L.1 aJardine M1 aPerkovic Vlado00aTripterygium Preparations for the Treatment of CKD: A Systematic Review and Meta-analysis  a2013/05/153 a<p>
BACKGROUND: Preparations of the herb Tripterygium wilfordii Hook F are used widely for the treatment of chronic kidney disease in China. The efficacy and safety of Tripterygium preparations still have not been fully identified. STUDY DESIGN: Systematic review and meta-analysis. SETTING &amp; POPULATION: Patients with chronic kidney disease. SELECTION CRITERIA FOR STUDIES: Randomized controlled trials. INTERVENTION: Tripterygium preparations (Tripterygium glycoside tablets, Tripterygium hypoglaucum Hutch tablets, and Tripterygium granules or extracts) versus placebo, standard care, or other immunosuppressive treatment. OUTCOMES: Weighted mean difference and summary estimates of relative risk (RR) reductions with 95% CIs were calculated with a random-effects model. Outcomes analyzed included change in proteinuria, serum creatinine level, and creatinine clearance rate, as well as remission and relapse rate and drug-related adverse events. RESULTS: We identified 75 trials that included 4,386 participants. Overall, Tripterygium therapy reduced proteinuria by protein excretion of 628 (95% CI, -736 to -521) mg/d and reduced serum creatinine level by 0.12 (95% CI, -0.17 to -0.06) mg/dL compared with controls (both P &lt; 0.001) in a range of kidney conditions. Tripterygium preparations also increased the rate of complete remission by 56% (95% CI, 32%-85%; P &lt; 0.001) and of complete or partial remission by 24% (95% CI, 17%-31%; P &lt; 0.001) while reducing relapse by 58% (95% CI, 42%-69%; P &lt; 0.001). Tripterygium preparations increased the rate of liver function test result abnormalities (RR, 4.03; 95% CI, 2.24-7.25; P &lt; 0.001) and altered menstruation (RR, 5.29; 95% CI, 2.09-13.38; P &lt; 0.001). LIMITATIONS: Suboptimal study quality, significant heterogeneity in the primary outcome. CONCLUSIONS: Tripterygium preparations may have nephroprotective effects, but high-quality trials are required to reliably determine the balance of benefits and harms.
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