Backgrounds Diabetic nephropathy (DN) is one of the most important clinical complications of diabetes mellitus (DM) and is the most common cause of end-stage renal disease. Currently, there is no highly effective medicine that can prevent, halt, or reverse the progressive course of DN. Initial clinical data showed that Tripterygium glycosides (TGs), a traditional Chinese medicine, can decrease proteinuria in patients with DN. Objectives The objective of the present study is to investigate the efficacy and safety of TGs for the treatment of DN through meta-analysis of randomized controlled trials (RCTs). Methods All RCTs of TGs for DN were collected from The China National Knowledge Infrastructure (CNKI), PubMed, Web of Science, Wanfang Data, Chinese Biomedical Literature Database (CBM), China Science and Technology Journal Database (VIP) by setting the study inclusion and elimination standards. Two reviewers evaluated the quality of the trials and extracted the data independently. RevMan 5.4 software was used for meta-analyses. The primary outcome was a change in 24-hours urinary total protein (24 h TUP). Results 26 RCTs with 1824 participants were identified. Studies were assessed using the Cochrane risk of bias tool. The overall effects showed that TGs was compared with the controls, TGs showed significant effects in reducing 24 h TUP [WMD = -0.84, 95 % CI (-1.09, -0.59)], elevating serum albumin [WMD = 2.88, 95 % CI (1.87, 3.90)], and the total efficiency [OR = 4.08, 95 % CI (2.37, 7.04)]. This effect was consistent across the subgroups of period of intervention. Conclusions The present research showed that TGs was significantly associated with improvement of renal function in patients with DN. TGs offers a novel approach to the treatment of DN, more high-quality RCTs are needed for a better understanding of the role of TGs in DN therapy.

Backgrounds: Diabetic nephropathy (DN) is one of the most important clinical complications of diabetes mellitus (DM) and is the most common cause of end-stage renal disease. Currently, there is no highly effective medicine that can prevent, halt, or reverse the progressive course of DN. Initial clinical data showed that Tripterygium glycosides (TGs), a traditional Chinese medicine, can decrease proteinuria in patients with DN.Objectives: The objective of the present study is to investigate the efficacy and safety of TGs for the treatment of DN by meta-analysis of randomized controlled trials (RCTs). Methods: All RCTs of TGs for DN were collected from The China National Knowledge Infrastructure (CNKI), Web of Science, Wanfang Data, Chinese Biomedical Literature Database (CBM), China Science and Technology Journal Database (VIP ) by setting the study inclusion and elimination standards. Two reviewers evaluated the quality of the trials and extracted the data independently. RevMan 5.4 software was used for meta-analyses. The primary outcome was a change in 24-hours urinary total protein (24h TUP). Results: 26 RCTs with 1824 participants were collected for detailed evaluation. The meta-analysis results indicated that TGs was compared with the controls, TGs showed significant effects in reducing 24h TUP [WMD = -0.84, 95%CI (-1.09, -0.59)], elevating serum albumin [WMD = 2.88, 95% CI (1.87, 3.90)], and the total efficiency [OR =4.08, 95% CI (2.37, 7.04)]. This effect was consistent across the subgroups of period of intervention. Conclusions: The present research showed that TGs was significantly associated with improvement of renal function in patients with DN. TGs offers a novel way in treating DN, more high quality RCTs are needed for better understanding of the role of TGs in DN therapy.