Antioxidant for treatment of diabetic nephropathy: A systematic review and meta-analysis

Diabetic nephropathy (DN) is one of the leading causes of morbidity and mortality amongst the diabetes mellitus patients. Oxidative stress played a major role in the pathogenesis of DN. Many studies reported that therapies with antioxidant potential have a beneficial effect on DN but there is conflicting evidence amongst them.

To elucidate the association between antioxidant and DN and to develop a robust evidence for clinical decisions by conducting systematic reviews and meta-analysis.

A comprehensive systematic literature search was conducted in PubMed, EMBASE, Cochrane Library, CPCI-S, ICTRP, and Google Scholar till February 2017 by two independent researchers. Various outcomes were included and statistical analyses were performed using RevMan V.5.3.

There were total 1461 participants identified from twelve studies, of which 882 (60.37%) were monitored on antioxidant treatment. Results indicated that antioxidant treatment was associated with significantly change in Blood Urea Nitrogen (SMD = 1.11, 95% CI: 0.38 to 1.85, p = 0.003), urinary Transforming Growth Factor-β (SMD = 2.16, 95% CI: -0.01 to 4.33; p = 0.05) and estimated Glomerular filtration Rate (SMD = 0.30, 95% CI: 0.06 to 0.55; p = 0.02) than control group. There was no association of change in urine albumin-to-creatinine ratio, serum creatinine, adverse events and rate of death with antioxidant treatment.

The findings of this investigation indicate that antioxidant treatment is effective clinically for DN treatment in T2DM patient. However, there is a need of high degree of caution for interpreting the outcomes of the studies with a short duration of antioxidant treatment.