Efficacy of Shenkang Injection combined with renin-angiotensin-aldosterone system blockers in diabetic nephropathy: a systematic review and meta-analysis of randomized controlled trials

Objective Shenkang injection (SKI), a Traditional Chinese Medicine formulation, is widely used in China for diabetic nephropathy (DN). This systematic review and meta-analysis aimed to evaluate the efficacy and safety of SKI combined with renin-angiotensin-aldosterone system (RAAS) blockers in patie...

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Main Authors: Xinyue Zhang, Xuyuan Lao, Shengchun Liao, Chaoyang Ye, Chen Wang
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2025.2499231
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author Xinyue Zhang
Xuyuan Lao
Shengchun Liao
Chaoyang Ye
Chen Wang
author_facet Xinyue Zhang
Xuyuan Lao
Shengchun Liao
Chaoyang Ye
Chen Wang
author_sort Xinyue Zhang
collection DOAJ
description Objective Shenkang injection (SKI), a Traditional Chinese Medicine formulation, is widely used in China for diabetic nephropathy (DN). This systematic review and meta-analysis aimed to evaluate the efficacy and safety of SKI combined with renin-angiotensin-aldosterone system (RAAS) blockers in patients with DN.Methods A comprehensive search of seven databases was conducted up to September 18, 2024, for randomized controlled trials (RCTs) comparing SKI plus RAAS blockers versus RAAS blockers alone in DN patients. Meta-analysis was performed using RevMan 5.3 and Stata 17.0, with effect sizes expressed as weighted mean differences (WMDs) or odds ratios (ORs) with 95% confidence intervals (CIs).Results A total of 18 RCTs involving 1,497 patients were analyzed. Combination therapy significantly improved total effective rate (TER) (MD 2.61, 95% CI 1.62–2.64) and reduced key renal and metabolic markers. Urinary protein excretion rate (UPER), serum creatinine (SCr), blood urea nitrogen (BUN), 24-hour urinary protein (24h-UTP), total cholesterol (TC), and triglyceride (TG) levels all significantly decreased in the combination group. Subgroup analysis showed that patients aged ≤55 years had greater reductions in SCr (WMD −25.62, 95% CI −29.41 to −21.83) and BUN (WMD −2.51, 95% CI −2.75 to −2.27). Sensitivity analysis confirmed the robustness of findings. No publication bias was detected for TER, SCr, BUN, 24h-UTP, TG, and adverse reactions, though UPER and TC showed potential bias.Conclusion SKI combined with RAAS blockers may enhance renal function and metabolic profiles in DN patients. Further high-quality RCTs are needed to validate these findings and assess long-term safety.
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series Renal Failure
spelling doaj-art-bfe64d3fd2a048cbb87e4c223f656d1b2025-08-20T03:48:11ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2499231Efficacy of Shenkang Injection combined with renin-angiotensin-aldosterone system blockers in diabetic nephropathy: a systematic review and meta-analysis of randomized controlled trialsXinyue Zhang0Xuyuan Lao1Shengchun Liao2Chaoyang Ye3Chen Wang4Department of Nephrology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Cardiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Nephrology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Nephrology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Nephrology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaObjective Shenkang injection (SKI), a Traditional Chinese Medicine formulation, is widely used in China for diabetic nephropathy (DN). This systematic review and meta-analysis aimed to evaluate the efficacy and safety of SKI combined with renin-angiotensin-aldosterone system (RAAS) blockers in patients with DN.Methods A comprehensive search of seven databases was conducted up to September 18, 2024, for randomized controlled trials (RCTs) comparing SKI plus RAAS blockers versus RAAS blockers alone in DN patients. Meta-analysis was performed using RevMan 5.3 and Stata 17.0, with effect sizes expressed as weighted mean differences (WMDs) or odds ratios (ORs) with 95% confidence intervals (CIs).Results A total of 18 RCTs involving 1,497 patients were analyzed. Combination therapy significantly improved total effective rate (TER) (MD 2.61, 95% CI 1.62–2.64) and reduced key renal and metabolic markers. Urinary protein excretion rate (UPER), serum creatinine (SCr), blood urea nitrogen (BUN), 24-hour urinary protein (24h-UTP), total cholesterol (TC), and triglyceride (TG) levels all significantly decreased in the combination group. Subgroup analysis showed that patients aged ≤55 years had greater reductions in SCr (WMD −25.62, 95% CI −29.41 to −21.83) and BUN (WMD −2.51, 95% CI −2.75 to −2.27). Sensitivity analysis confirmed the robustness of findings. No publication bias was detected for TER, SCr, BUN, 24h-UTP, TG, and adverse reactions, though UPER and TC showed potential bias.Conclusion SKI combined with RAAS blockers may enhance renal function and metabolic profiles in DN patients. Further high-quality RCTs are needed to validate these findings and assess long-term safety.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2499231Shenkang InjectionRenin-angiotensin-aldosterone system (RAAS) blockerstraditional Chinese medicinediabetic nephropathysystematic reviewmeta-analysis
spellingShingle Xinyue Zhang
Xuyuan Lao
Shengchun Liao
Chaoyang Ye
Chen Wang
Efficacy of Shenkang Injection combined with renin-angiotensin-aldosterone system blockers in diabetic nephropathy: a systematic review and meta-analysis of randomized controlled trials
Renal Failure
Shenkang Injection
Renin-angiotensin-aldosterone system (RAAS) blockers
traditional Chinese medicine
diabetic nephropathy
systematic review
meta-analysis
title Efficacy of Shenkang Injection combined with renin-angiotensin-aldosterone system blockers in diabetic nephropathy: a systematic review and meta-analysis of randomized controlled trials
title_full Efficacy of Shenkang Injection combined with renin-angiotensin-aldosterone system blockers in diabetic nephropathy: a systematic review and meta-analysis of randomized controlled trials
title_fullStr Efficacy of Shenkang Injection combined with renin-angiotensin-aldosterone system blockers in diabetic nephropathy: a systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed Efficacy of Shenkang Injection combined with renin-angiotensin-aldosterone system blockers in diabetic nephropathy: a systematic review and meta-analysis of randomized controlled trials
title_short Efficacy of Shenkang Injection combined with renin-angiotensin-aldosterone system blockers in diabetic nephropathy: a systematic review and meta-analysis of randomized controlled trials
title_sort efficacy of shenkang injection combined with renin angiotensin aldosterone system blockers in diabetic nephropathy a systematic review and meta analysis of randomized controlled trials
topic Shenkang Injection
Renin-angiotensin-aldosterone system (RAAS) blockers
traditional Chinese medicine
diabetic nephropathy
systematic review
meta-analysis
url https://www.tandfonline.com/doi/10.1080/0886022X.2025.2499231
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