The Safety and Efficacy of Using Uremic Clearance Granules for Treating Stages 3 to 5 of Chronic Kidney Disease: A Meta-analysis

Abstract

ABSTRACT Background: To evaluate the effectiveness and safety of uremic clearance granules for treating stages 3 to 5 of chronic kidney disease (CKD), and to provide evidence-based support for the clinical application of uremic clearance. Methods: All randomized controlled trials (RCTs) addressing the use of uremic clearance granules for the treatment of CKD were collected from China Biology Medicine (CBM) database, China National Knowledge Infrastructure (CNKI), WanFang Data, PubMed, Cochrane Library, and Web of Science. After two researchers had independently screened and extracted data, the quality of the included literature was evaluated according to the modified Jadad rating scale. Finally, Stata11 was used for the meta analysis. Results: A total of 36 RCTs were obtained that included 3058 patients, comprising 1538 experimental group and 1520 control group participants. Meta analysis indicated that uremic clearance granules treatment yielded promising results in lowering the levels of serum creatinine (Scr, weekly hemodialysis [WHD] = −52.42, 95% confidence interval [CI]: −62.64 to −42.21), triglyceride (TG, WHD = −0.45, 95% CI: −0.85 to −0.04), total cholesterol (TC, WHD = −1.41, 95% CI: −1.78 to −1.04) and increasing the glomerular filtration rate (GFR, WHD = 3.26, 95% CI: 3.70 to 6.99) and hemoglobin (HB, WHD = 5.79, 95% CI: 2.66 to 8.92) levels. In addition, this treatment can improve the overall signs and symptoms of patients with CKD [relative risk (RR) = 1.37, 95% CI: 1.24 to 1.51]. However, there was no statistically significant reduction in the 24 hours total urine protein (24hUpro) Hb levels (WHD = −194.95, 95% Cl: −425.92 to 36.01) compared with control therapy alone. Conclusion: Uremic clearance granules treatment significantly reduced Scr, TG, TC levels and increased GFR and HB levels while improving the signs and symptoms of patients with CKD. Due to the low quality of the methodological approaches used in the included studies, further high quality research initiatives are needed to further explore the merits of this therapy.