Table 6.
Results of Evidence Quality
| Author, Year (Country) | Outcomes | Studies (Participants) | Limitations | Inconsistency | Indirectness | Imprecision | Publication Bias | Effect Size (95% CI) | P-value | Quality |
|---|---|---|---|---|---|---|---|---|---|---|
| JinYing Fang, 202031 | 24h-UTP | 9 (851) | Serious① | Serious② | No | No | No | WMD=−0.34(−0.38,-0.30) | P<0.00001 | Low |
| SCr | 8 (781) | Serious① | No | No | No | No | WMD=−9.87(−13.76, −5.97) | P<0.00001 | Moderate | |
| Huabin Guo, 202132 | 24h-UTP | 24 (847) | No | Serious② | No | No | No | WMD=−0.84(−1.09, −0.59) | P<0.00001 | Moderate |
| Alb | 15 (976) | No | No | No | No | Serious④ | WMD=2.88(1.87, 3.90) | P<0.00001 | Moderate | |
| SCr | 23 (1628) | No | Serious② | No | No | No | WMD=−4.77(−4.78, −1.75) | P=0.002 | Moderate | |
| BUN | 9 (774) | No | Serious② | No | Serious③ | Serious④ | WMD=−0.37(−0.79, 0.04) | P=0.08 | Very low | |
| CCr | 7 (476) | No | No | No | No | Serious④ | SMD=0.42(0.24, 0.60) | P<0.00001 | Moderate | |
| Total clinical efficacy | 5 (571) | No | No | No | No | Serious④ | OR=4.08, 95% CI (2.37, 7.04) | P<0.00001 | Moderate | |
| Adverse reactions | ALT | 10 (539) | Serious① | No | No | Serious③ | Serious④ | WMD=1.18(−0.68, 3.04) | P=0.21 | Very low |
| WBC | 8 (533) | No | No | No | No | Serious④ | WMD=−0.26(−0.38, −0.14) | P<0.00001 | Moderate | |
| Yizhen Li, 202133 | 24h-UTP(3 months) | 14 (1120) | Serious① | Serious② | No | No | Serious④ | WMD=0.30(–0.35, –0.25) | P<0.00001 | Very low |
| 24h-UTP(6 months) | 7 (708) | Serious① | Serious② | No | No | Serious④ | WMD=−0.91(−1.27, −0.56) | P<0.00001 | Very low | |
| SCr(3 months) | 12 (1002) | Serious① | Serious② | No | No | Serious④ | WMD=−12.63(−21.96, −3.31) | P=0.008 | Very low | |
| SCr(6 months) | 8 (780) | Serious① | Serious② | No | No | Serious④ | WMD=−2.85(−5.03, −0.68) | P=0.01 | Very low | |
| Adverse reactions | Adverse reactions (3 months) events | 13 (1148) | Serious① | No | No | No | No | WMD=2.02(1.35, 3.00) | P=0.006 | Moderate |
| Adverse reactions (6 months) events | 11 (1032) | Serious① | No | No | No | No | WMD=3.49(1.96, 6.22) | P<0.00001 | Moderate | |
| Wanchun Ye, 201834 | Total clinical efficacy | 6 (494) | No | No | No | No | No | RR=1.35 (1.22, 1.50) | P<0.00001 | High |
| 24h-UTP | 12 (829) | No | Serious② | No | No | No | WMD=−0.97(−1.19, -0.76) | P<0.00001 | Moderate | |
| SCr | 9 (532) | No | Serious② | No | Serious③ | No | WMD=−0.26(−7.52, 7.00) | P=0.94 | Low | |
| Alb | 8 (417) | No | No | No | No | No | WMD=3.87(3.12, 4.62) | P<0.00001 | High | |
| UAER | 2 (278) | Serious① | Serious② | No | No | Serious⑤ | WMD=−145.53(−227.95, −63.11) | P<0.00001 | Very low | |
| Urinary β2-microglobulin | 2 (278) | Serious① | No | No | No | Serious⑤ | WMD=−11.86(−13.02, −10.69) | P<0.00001 | Low | |
| BUN | 2 (120) | Serious① | No | No | Serious③ | No | WMD=0.25 (−0.23, 0.74) | P=0.31 | Low | |
| Endogenous creatinine clearance rate | 3 (177) | No | No | No | Serious③ | No | WMD=−0.43(−3.48, 2.62) | P=0.78 | Moderate | |
| Adverse reactions | Adverse reaction rate | 8 (448) | No | No | No | No | No | RR=3.41 (1.34, 8.66) | P=0.01 | High |
| Xue Wu, 202135 | 24h-UTP | 18 (1339) | Serious① | Serious② | No | No | Serious④ | SMD=−1.46(−1.84, −1.09) | P<0.00001 | Very Low |
| UAER | 5 (500) | Serious① | Serious② | No | No | Serious④ | SMD=−6.9(−9.65, −4.14) | P<0.00001 | Very Low | |
| SCr | 18 (1397) | Serious① | Serious② | No | No | Serious④ | WMD=−7.65(−12.99, −2.31) | P<0.00001 | Very Low | |
| BUN | 6 (487) | Serious① | No | No | Serious③ | Serious④ | WMD=−0.06(−0.25, 0.13) | P=0.51 | Very Low | |
| Alb | 12 (737) | Serious① | No | No | No | Serious④ | WMD=5.7(4.44, 6.96) | P<0.00001 | Low | |
| HbA1c | 6 (447) | Serious① | No | No | Serious③ | Serious④ | WMD=−0.08(−0.22, 0.06) | P=0.24 | Very Low | |
| Adverse reactions | ALT | 6 (270) | Serious① | No | No | Serious③ | Serious④ | WMD=1.08(0.04, 2.12) | P=0.04 | Very Low |
| Ying Wang, 202036 | 24h-UTP | 17 (1033) | Serious① | Serious② | No | No | Serious④ | WMD=−0.95(−1.17, −0.74) | P<0.00001 | Very Low |
| SCr | NR | Serious① | Serious② | No | Serious③ | Serious④ | NR | P>0.05 | Very Low | |
| eGFR | NR | Serious① | Serious② | No | Serious③ | Serious④ | NR | P>0.05 | Very Low | |
| Alb | 13 (1148) | Serious① | No | No | No | Serious④ | WMD=2.53(1.44, 3.62) | P<0.00001 | Low | |
| Adverse reactions | Adverse reaction rate | 15 (951) | Serious① | No | No | No | No | RR=2.22(1.32, 3.73) | P=0.03 | Moderate |
| Huan Chen, 202037 | CRP | 9 (589) | Serious① | No | No | No | Serious④ | WMD=1. 89(1. 64, 2. 15) | P<0.00001 | Low |
| IL-6 | 6 (557) | Serious① | Serious② | No | No | Serious④ | WMD=3. 79(2. 51, 5. 07) | P<0.00001 | Very Low | |
| TNF-α | 8 (709) | Serious① | No | No | No | Serious④ | WMD=0. 40(0. 31, 0. 49) | P<0.00001 | Low | |
| Adverse reactions | Leukopenia rate | 6 (575) | Serious① | No | No | No | Serious④ | OR=4. 33(1. 08, 17. 47) | P=0.04 | Low |
| Abnormal liver function rate | 6 (448) | Serious① | No | No | No | Serious④ | OR=3. 73(1. 12, 12. 35) | P=0.03 | Low | |
| Adverse gastrointestinal reaction rate | 6 (526) | Serious① | No | No | Serious③ | Serious④ | OR=0(−0. 04, 0. 04) | P=0.94 | Very Low | |
| Jing Huang, 201538 | Total clinical efficacy | 9 (617) | Serious① | No | No | No | Serious④ | OR=4. 32(2. 77, 6. 46) | P<0.00001 | Low |
| 24h-UTP | 12 (1033) | Serious① | Serious② | No | No | No | WMD=−0. 84(−1. 02, −0. 66) | P<0.00001 | Low | |
| Alb | 9 (1033) | Serious① | No | No | No | Serious④ | SMD=0. 98(0. 83, 1. 13) | P<0.00001 | Low | |
| SCr | 10 (787) | Serious① | No | No | Serious③ | Serious④ | WMD=1.35(−0.05, 2.74) | P=0.06 | Very Low | |
| Adverse reactions | Adverse reaction rate | 7 (306) | Serious① | No | No | No | Serious④ | RD=0.07(0.03, 0.12) | P=0.0008 | Low |
| Kui Liu, 201939 | Total clinical efficacy | 10 (787) | Serious① | No | No | No | Serious④ | OR=6.10(3.93, 9.48) | P<0.00001 | Low |
| 24h-UTP | 16 (1475) | Serious① | Serious② | No | No | Serious④ | SMD=−1.27(−2.04, −0.51) | P=0.001 | Very Low | |
| SCr | 10 (787) | Serious① | Serious② | No | No | Serious④ | WMD=−7.49(−13.83, −1.15) | P=0.02 | Very Low | |
| Adverse reactions | Adverse reaction rate | 7 (617) | Serious① | No | No | No | Serious④ | RD=0.07(0.03, 0.11) | P=0.0002 | Low |
| Xinhua Liang, 201640 | Alb | 8 (425) | No | Serious② | No | No | Serious④ | WMD=3.52(0.80, 6.25) | P=0.01 | Low |
| SCr | 7 (446) | No | Serious② | No | No | Serious④ | WMD=−15.25(−23.84, −6.66) | P=0.0005 | Low | |
| 24h-UTP | 6 (275) | No | Serious② | No | No | Serious④ | WMD=−0.66(−0.89, −0.42) | P<0.00001 | Low | |
| BUN | 5 (343) | No | No | No | Serious③ | Serious④ | WMD=−0.05(−0.36, 0.27) | P=0.77 | Low | |
| Mengjiu Zhang, 202041 | 24h-UTP | 16 (1015) | Serious① | No | No | No | Serious④ | SMD=−0.78(−1.03,-0.54) | P<0.00001 | Low |
| Alb | 13 (767) | Serious① | No | No | No | Serious④ | SMD=0.61(0.34,0.87) | P<0.00001 | Low | |
| SCr | 15 (950) | Serious① | Serious② | No | No | Serious④ | SMD=−0.44(−0.85,-0.03) | P<0.00001 | Very Low | |
| BUN | 7 (543) | Serious① | No | No | No | Serious④ | WMD=−0.30(−0.59, −0.01) | P=0.04 | Low | |
| Adverse reactions | ALT | 14 (825) | Serious① | Serious② | No | No | Serious④ | SMD=0.26(−0.06, 0.59) | P=0.04 | Very Low |
| WBC | 10 (614) | Serious① | No | No | Serious③ | Serious④ | WMD=−0.29(−0.72, 0.14) | P=0.18 | Very Low | |
| Adverse reaction rate | 13 (830) | Serious① | No | No | No | Serious④ | RR=1.97(1.22, 3.19) | P=0.006 | Low | |
| Guoshuang Zhu, 201942 | Total clinical efficacy | 4 (254) | Serious① | No | No | No | Serious④⑤ | OR=3.91(1.91,8.01) | P=0.0002 | Low |
| 24h-UTP | 9 (498) | Serious① | No | No | No | Serious④ | WMD=−0.53(−0.77, 0.29) | P<0.00001 | Low | |
| BUN | 3 (220) | Serious① | Serious② | No | No | Serious④ | WMD=−2.2(−2.79, −1.61) | P<0.00001 | Very Low | |
| SCr | 4 (196) | Serious① | No | No | Serious③ | Serious④ | WMD=−5.79(−11.04, 0.11) | P=0.05 | Very Low | |
| Adverse reactions | Adverse reaction rate | 9 (610) | Serious① | No | No | Serious③ | Serious④ | OR=1.01(0.56,1.82) | P=0.46 | Very Low |
| Dandan Xie 202243 | UAER | 9 (694) | Serious① | No | No | No | Serious④ | SMD=−2.55 (−4.70, −0.40) | P=0.02 | Low |
| 24h-UTP | 27 (1842) | Serious① | No | No | No | No | WMD= −0.79 (−1.22, −0.36) | P = 0.0003 | Moderate | |
| SCr | 25 (1698) | Serious① | Serious② | No | No | No | WMD=−8.23 (−14.48, −1.99) | P = 0.01 | Low | |
| Alb | 17 (1174) | Serious① | Serious② | No | No | No | WMD= 4.70 (3.27, 6.13) | P<0.00001 | Low | |
| Adverse reaction rate | 20 (1351) | Serious① | No | No | No | Serious④ | RR=2.55 (1.57, 4.13) | P<0.00001 | Low |
Notes: ①The included studies had a large bias in methodology such as randomization, allocation concealment, and blinding. ②The confidence interval overlapped less or the I2 value of the combined results was larger. ③The sample size from the included studies did not meet the optimal sample size or the 95% confidence interval crossed the invalid line. ④The funnel chart was asymmetry. ⑤Fewer studies were included, and their results were all positive, which may result in a large publication bias.
Abbreviations: CT, conventional treatment; 24-UTP, 24 h-urine total protein; SCr, serum creatinine; Alb, serum albumin; BUN, blood urea nitrogen; UAER, urinary albumin excretion rates; eGFR, glomerular filtration rate; CRP, c-reactive protein, IL-6, interleukin-6; TNF-α, tumor necrosis factor-α; ACEI, angiotensin-converting enzyme inhibitors; ARB, angiotensin receptor blockers; WBC, white blood cell.