Protective Effect of Melatonin for Renal Ischemia-Reperfusion Injury: A Systematic Review and Meta-Analysis

Abstract

Background: Renal ischemia-reperfusion (I/R) injury is one of the major causes related to acute kidney damage. Melatonin has been shown as a powerful antioxidant, with many animal experiments have been designed to evaluate the therapeutic effect of it to renal I/R injury.Objectives: This systematic review aimed to assess the therapeutic effect of melatonin for renal I/R injury in animal models.Methods and Results: The PubMed, Web of Science, Embase, and Science Direct were searched for animal experiments applying melatonin to treat renal I/R injury to February 2021. Thirty-one studies were included. The pooled analysis showed a greater reduction of blood urea nitrogen (BUN) (21 studies, weighted mean difference (WMD) = −30.00 [−42.09 to −17.91], p < 0.00001), and serum creatinine (SCr) (20 studies, WMD = −0.91 [−1.17 to −0.66], p < 0.00001) treated with melatonin. Subgroup analysis suggested that multiple administration could reduce the BUN compared with control. Malondialdehyde and myeloperoxidase were significantly reduced, meanwhile, melatonin significantly improved the activity of glutathione, as well as superoxide dismutase. The possible mechanism for melatonin to treat renal I/R injury is inhibiting endoplasmic reticulum stress, apoptosis, inflammation, autophagy, and fibrillation in AKI to chronic kidney disease.Conclusions: From the available data of small animal studies, this systematic review demonstrated that melatonin could improve renal function and antioxidative effects to cure renal I/R injury through, then multiple administration of melatonin might be more appropriate. Nonetheless, extensive basic experiments are need to study the mechanism of melatonin, then well-designed randomized controlled trials to explore the protective effect of melatonin.

Protective Role of Melatonin for Acute Kidney Injury: A Systematic Review and Meta-Analysis

“…Melatonin shows a protective effect against renal ischemia reperfusion injury, cisplatin-induced nephrotoxicity, reteral obstruction induced renal injury, and radiation injury to kidneys. First of all, melatonin improves renal function and has antioxidative effects on renal ischemia reperfusion injury (16)(17)(18). Moreover, melatonin improves the recovery of renal function through reducing endoplasmic reticulum stress and stimulating the Akt pathway after renal ischemia reperfusion injury (45).…”

“…Currently, numerous animal experimental studies about the therapeutic effect of melatonin on renal ischemia reperfusion injury have been published (15)(16)(17)(18). Surprisingly, in animal experiments, melatonin used in combination with chemotherapeutic agents reduces nephrotoxicity (19).…”

Melatonin Treatment in Kidney Diseases

“…There are several examinations that suggest a potential therapeutic effect of melatonin in minimizing renal injury during ischemia and reperfusion [ 197 , 198 , 199 ]. A histopathological assessment of kidney injury after melatonin treatment showed that the damage was smaller [ 197 ].…”

The Analgesic Effect and Potential Mechanisms of Acupuncture for Migraine Rats: A Systematic Review and Meta-Analysis

“…The following information was extracted: the first author's last name, year of publication, animal strain, gender, migraine modeling methodology, number of animals in intervention or control groups, acupuncture manipulation methods (acupoints, electrical stimulator parameters, depth, sessions and retention time), the underlying mechanism of acupuncture, outcome measures, data of mean outcome and standard deviation. If only a chart was used to display the results, the data was gathered by using the software GetData Graph Digitizer 22,23 to accurately measure the values. We attempted to contact the authors to collect the detailed data if the meta-analysis data was missing.…”