Huangkui capsules for diabetic nephropathy: Comprehensive review of efficacy and molecular mechanisms

The management of kidney diseases urgently needs additional therapeutic options. Encouraging evidence suggests the efficacy of Huangkui capsules (HKCs), a plant-derived traditional medicine, in treating various subtypes of nephropathy. However, current evidence is fragmented between clinical outcomes and mechanistic insights.

This study synthesized randomized controlled trials (RCTs), meta-analysis, and preclinical data to explore the effectiveness and mechanisms of action of HKCs.

Evidence map and meta-analysis.

Seven databases were searched for RCTs and meta-analysis on the use of HKCs for nephropathies, as well as animal studies examining the effects of HKCs on diabetic nephropathy (DN). Data on baseline information, renal function indicators, glycemic control, lipid profiles, and inflammatory markers were extracted. Evidence was synthesized using a meta-analytical approach.

Our evidence map highlighted the effect of HKCs on DN, particularly on urinary protein excretion as a key outcome measure. In the meta-analysis of clinical studies, HKCs demonstrated significant improvements in renal function indicators, inflammatory markers, and lipid profiles. In the meta-analysis of animal studies, HKCs demonstrated significant beneficial effects on renal function in DN models. Specifically, substantial reductions in 24-hour urine protein values were observed in the high-dose group (100-200 mg/kg). Mechanistic reviews indicated that HKCs exert a multi-target, comprehensive regulatory effect on DN.

This study provides compelling and robust evidence supporting the clinical translation of HKCs and highlights their value as a therapeutic option for nephropathies, particularly in the context of DN.