Efficacy and safety of the Fu-Zheng-Qu-Zhuo method on retarding the progress of chronic kidney disease (stage 3-4): a systematic review and meta-analysis.

BACKGROUND

To evaluate the efficacy and safety of a traditional Chinese medicine (TCM), Fu-Zheng-Qu-Zhuo, on retarding the progress of stage 3-4 chronic kidney disease (CKD).

METHODS

We searched the relevant randomized controlled trials (RCTs) from the Medline, Cochrane Library, Embase, SinoMed, Wanfang, CNKI, and Weipu (VIP) databases from their inception to June 2018. Conference proceedings, and reference lists of relevant articles and two reviewers, independently identified the relevant studies. RevMan software was used for statistical analysis. The fixed-effect model was applied if there was either no or low heterogeneity, and pooled odds ratios (ORs) were estimated using the Mantel-Haenszel method. Publication bias was assessed if there were more than ten studies in one outcome. All hypotheses were tested at the alpha =0.05 level.

RESULTS

Ten studies with 1,308 participants were included, and eight studies were included in the meta-analysis. Compared with the control group, the occurrence of composite endpoint events (defined as the initiation of dialysis, CKD-related death, or the doubling of serum creatinine) was significantly reduced in the treatment group [risk ratio (RR) =0.56, 95% CI: 0.33-0.94, P=0.029, I=0.0%]. In addition, it did not increase the risk of hyperkalemia (RR =1.43, 95% CI: 0.85-2.42, P=0.180, I=0.0%).

CONCLUSIONS

In conclusion, the Fu-Zheng-Qu-Zhuo method combined with integrated therapy decreased the occurrence of composite endpoint events and retarded the progress of stage 3-4 CKD. In addition, there was no increase in the risk of hyperkalemia. We recommend the use of the Fu-Zheng-Qu-Zhuo method combined with integrated therapy for stage 3-4 CKD.