ABSTRACT
It remains controversial, whether vitamin D reduces urinary albumin excretion in patients with diabetic nephropathy (DN). This metaanalysis was designed to evaluate the therapeutic effect of vitamin D, on urinary albumin excretion, in DN patients. Electronic databases, including PubMed, Embase, Web of Science, and Cochrane library were searched for randomized controlled trials (RCTs), regarding the effect of vitamin D on urinary albumin excretion in DN patients. The study selection and data extraction were conducted by two reviewers independently, and statistical analysis was performed using RevMan software, version 5.2. A total of nine RCTs including 1547 subjects were qualified. There were 815 participants in the study group and 732 in the control group. The fixed-effect model was used to analyze urinary albumin creatinine ratio (UACR) and urinary albumin excretion ratio (UAER), and the pooled standard mean difference (SMD) was -0.24 (95% CI: -0.39 to -0.09), P = .002, and -0.57 (95% CI: -0.71 to -0.43), P < .00001; respectively. These findings indicated that vitamin D-treated patients had a statistically significant reduction in UACR and UAER. High-quality RCTs are still required. DOI: 10.52547/ijkd.7107.
Subject(s)
Diabetes Mellitus , Diabetic Nephropathies , Albumins/therapeutic use , Creatinine , Humans , Randomized Controlled Trials as Topic , Vitamin D/therapeutic use , VitaminsABSTRACT
PURPOSE: The purpose of this study was to systematically assess the efficacy of fish oil therapy on maintenance hemodialysis patients (MHD). METHODS: Electronic databases, including PubMed, Cochrane library, EMBase, and Web of Science, were searched for randomized controlled trials (RCTs) of fish oil versus placebo or no treatment in MHD patients. The study selection and data extraction were conducted independently by two reviewers, and statistical analysis was performed using RevMan software, version 5.2. RESULTS: A total of thirteen eligible RCTs involving 916 subjects (461 in the experimental group and 455 in the control group) were included. The meta-analysis showed that fish oil significantly reduced arteriovenous graft (AV-graft) events [risk ratio (RR) 0.71, 95 % confidence interval (CI) were (0.52, 0.97)] and cardiovascular events [RR (95 %CI) were 0.41 (0.26, 0.66)] in the fish oil group. In addition, compared with the control group, fish oil significantly decreased the Beck Depression Inventory (BDI) score [weighted mean difference (WMD) (95 %CI) were -11.91 (-15.88, -7.95)], serum intact parathyroidism (iPTH), C-reactive protein (CRP), and triglycerides (TG) [standard mean difference (SMD) (95 %CI) were -0.56 (-0.89, -0.23); -0.36 (-0.63, -0.09), and -0.41 (-0.68, -0.14), respectively]. However, the fish oil group did not differ significantly from the control group in albumin (ALB), hemoglobin (Hb), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and mortality. CONCLUSIONS: Fish oil reduced the risk of AV-graft events and cardiovascular events, and alleviated depression symptoms in MHD patients. It can also improve secondary hyperparathyroidism, micro-inflammation, and hypertriglyceridemia. But there is no evidence that fish oil can improve nutritional status and renal anemia.
