Objective. Traditional Chinese medicine (TCM) has a long history in the treatment of Immunoglobulin A nephropathy (IgAN). A large number of animal experiments focused on the TCM treatment of IgAN are conducted every year. The evidence for these preclinical studies is not clear. This study summarized and evaluated the results of animal experiments on TCM treatment for IgAN. Methods. We systematically searched animal studies from 6 databases from inception to August 30, 2022. We included Chinese studies from the key magazine of China technology. The quality of the included studies was evaluated with the SYRCLE animal experimental bias risk assessment tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results. Out of 832 records identified in the initial search, 30 studies were selected. The results indicated that, compared with the control group, the TCM treatment group improved 24 h urine protein (24 h-UP) level (standardized mean difference (SMD) 3.57, 95% confidence interval (CI) 4.48 to 2.66, ), urine red blood cell (U-RBC) (SMD 13.66, 95% CI 17.99 to 9.32, ), serum creatinine (Scr) (mean difference (MD) 10.89, 95% CI 17.00 to 4.77, ), blood urea nitrogen (BUN) (MD 2.44, 95% CI 3.42 to 1.47, ), tumor necrosis factor-α (TNF-α) (MD 171.28 to 95% CI 323.68 to 18.88, ), transforming growth factor-β1 (TGF-β) (SMD 4.02, 95% CI 7.26 to 0.77, ), matrix metalloproteinase-9/tissue inhibitors of metalloproteinase-1(MMP-9/TIMP-1) (MD 0.03, 95% CI 0.00 to 0.06, ), nephrin mRNA (SMD 3.39, 95% CI 2.59 to 4.18, ). However, there is no difference in albumin level (MD 1.10, 95% CI 0.06 to 2.26, ) and interleukin-6 (IL-6) (MD 170.77, 95% CI 365.3 to 23.75, ). Conclusions. TCM can improve 24 h-UP, U-RBC, Scr, BUN, MMP-9/TIMP-1, TNF-α, TGF-β, and nephrin mRNA of IgAN animal models. Moreover, there is a need for rigorous reporting of preclinical research methodology, which is essential to support the quality of preclinical research. Registration. This review was registered with a systematic review record CRD42020171404 in the PROSPERO database.

Ethnopharmacological relevance: Ophiocordyceps sinensis (O. sinensis), a genus of ascomycete fungi, has been widedly used in China as a dietary supplement or natural remedy and intensively studied in various disease models with its immunomodulatory potentials. It is a rich source of various bioactive compounds and used for treating end-stage renal disease. This systematic review with clinical evidence aimed to highlight the efficacy and safety of O. Sinensis as an adjuvant treatment for patients undergoing dialysis.Materials and methods: A systematic search through nine electronic databases up to 31 April 2024, was conducted for related studies. The Cochrane risk-of-bias tool was used to evaluate the quality of studies. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the certainty of evidence. Two researchers independently searched the literature and evaluated the risk of bias.Results: After the screening, 35 randomized controlled trials (RCTs) involving 2,914 patients were eventually included. The meta-analysis showed that using O. sinensis effectively reduced the following outcomes in patients undergoing dialysis: C-reactive protein (15RCTs, MD = −2.22, 95% CI −3.24 to −1.20; very low certainty evidence); creatinine (22RCTs, MD =1.33, 95% CI −1.79 to −0.87; very low certainty evidence); blood urea nitrogen (21RCTs, MD = −1.57, 95% CI −2.07 to −1.07; low certainty evidence);. It could also effectively improve the following outcomes in patients undergoing dialysis: albumin (20RCTs, MD = −0.81, 95% CI −1.21 to −0.41; low certainty evidence); hemoglobin (19RCTs, MD = −1.00, 95% CI −1.43 to −0.57; low certainty evidence). The rate of adverse drug reactions was higher in the control group than in the experimental group (4RCTs, MD = 1.81, 95% CI 0.88–3.74).Conclusion: The current evidence indicates that patients with dialysis receiving O. sinensis in the adjuvant treatment may improve nutritional and micro-inflammatory status and renal function for both hemodialysis and peritoneal dialysis patients. However, some limitation affected the generalizability of our findings. High-quality studies evaluating mortality outcomes of patients with different dialytic modalities in CKD are warranted in future.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324508, registration number CRD42022324508.

Background: Chronic renal failure (CRF) is a major public health problem worldwide nowadays. It is characterized by a slow reduction in kidney function identified by an increase of serum creatinine levels and a reduction of urine output. CRF is easier to diagnose than to treat. Clinical evidence shows that colonic dialysis combined with traditional Chinese medicine (TCM) enema can treat CRF by reducing serum creatinine. To assess the therapeutic efficacy and safety of colonic dialysis combined with Traditional Chinese medicine retention enema in CRF, we created a protocol for a systematic review to inform future clinical applications. Methods: Eligible random controlled trials were collected from 8 bibliographic databases (PubMed, EMBASE, Web of Science, The Cochrane Library, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Wanfang Database), completed before October 2021. The primary outcome is the serum creatinine, Urea nitrogen, total effective rate, uric acid, creatinine clearance. Secondary outcome: TCM syndrome score, glomerular filtration rate, hemoglobin, adverse reactions, and adverse events. Data extraction and quality assessment were independently conducted by 2 researchers. The quality and bias of the data were assessed using RevMan5.4 software. Results: This study will provide a clinical basis for colonic dialysis combined with TCM retention enema in the treatment of CRF. Conclusion: Colonic dialysis combined with TCM retention enema in the treatment of CRF can delay the progression of renal disease, proving its effectiveness and safety. INPLASY Registration number: INPLASY2021100116

Introduction: Diabetic kidney disease (DKD), a major microvascular complication of diabetes mellitus, is closely associated with abnormal lipid metabolism, which contributes to secondary renal injury. The JAML/SIRT1 signaling pathway plays a critical role in regulating renal lipid metabolism during DKD progression. To investigate the molecular mechanisms underlying the therapeutic effects of Wenyang Jiedu Tongluo Formula (WYJDTLF) on lipid metabolism in DKD, we conducted an animal study using db/db mice.Methods: The mice were treated with WYJDTLF for 4 weeks, and its efficacy was evaluated through assessments of liver and kidney function, lipid profiles, and renal histopathology. Renal injury was examined using Hematoxylin and Eosin (H&E), Periodic Acid-Schiff (PAS), and Masson’s trichrome staining. Podocyte damage was assessed by quantifying the expression of podocyte marker proteins (Nephrin and NPHS2) using quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Additionally, the expression levels of key proteins in the JAML/SIRT1 signaling pathway were analyzed via Western blot (WB).Results: The results demonstrated that WYJDTLF significantly improved liver and kidney function, reduced lipid deposition and inflammatory damage, and alleviated renal fibrosis and pathological injury. These effects were mediated through the regulation of the JAML/SIRT1 signaling pathway. Furthermore, WYJDTLF treatment upregulated the expression of Nephrin and NPHS2, indicating a protective effect on podocyte integrity.Conclusion: Our team has revealed for the first time that the WYJDTLF can improve lipid metabolism abnormalities in db/db mice and alleviate diabetic kidney disease-induced renal pathological damage by inhibiting the JAML/SIRT1 signalling pathway. These findings provide a scientific basis for the potential application of WYJDTLF in the treatment of DKD.