Table 2. Assessment of outcomes and efficacy of different AMS interventions.
aPercentage reduction in symptoms is computed using (mean score at baseline - mean score post-treatment at end of study)/(mean score at baseline) for the treatment group.
bTCM granules are formulated based on four TCM syndrome patterns (Qi Yin/Xue deficiency, blood stasis in the kidney, wind-dampness interfering in the kidney, and endoretention of damp heat) for the treatment of CKD.
cHerbal granules consist of ten herbs: Huangqi, Danggui, Huzhang, Liuyuexue, Tufuling, Niuxi, Shiwei, Dahuang, Jixuecao, and Huangjing.
dDosage and frequency vary from patient to patient.
99mTc-DTPA: 99 m technetium diethylenetri-aminepenta-aceticacid; ARB: angiotensin II receptor blockers; BAID: brachial arterial inner diameter; BIW: twice a week; BUN: blood urea nitrogen; CCR: creatinine clearance rate; CKD-EPI: chronic kidney disease-epidemiology collaboration; DQOL: diabetes quality of life; eGFR: estimated glomerular filtration rate; ESR: erythrocyte sedimentation rate; ELISA: enzyme-linked immunosorbent assay; EQ-5D: EuroQol-5 dimension; FBG: fasting blood glucose; GS-RB1: Ginsenoside Rb1; HbA1c: haemoglobin A1c; ITT: intention to treat; LF: low frequency; MDA: malondialdehyde; MDRD: modification of diet in renal disease; NI: no information; PP: per protocol; QD: once a day; QDDHG: Qidan Dihuang Grain; SCr: serum creatinine; TBN: Tianbaoning; TCM: traditional Chinese medicine; TIW: thrice a week; TSF: Tangshen formula; TwHF: Tripterygium Wilfordii Hook F; TUP: total urine protein; TUV: total urine volume; UAER: urinary albumin excretion rate; VAS: visual analog scale; WHOQOL-BREF: World Health Organization Quality of Life-100 Questionnaire; ZSTL: Zishentongluo; Hs-CRP: high-sensitivity c-reactive protein; ITT: intention to treat; QIW: four times a week; HIF-1α: hypoxia-inducible factor 1-alpha; Wnt1: Wnt family member 1; α-SMA: alpha smooth muscle actin; TNF-α: tumor necrosis factor alpha; TRAF6: tumor necrosis factor receptor associated factor 6; FN: Fibronectin
| Study (year of publication) | Indication for use of intervention | Treatment (dose and duration if available) | Comparator (dose and duration if available) | Tool(s) used to assess outcomes | Outcome | Improvement symptoms (yes / no) | Percentage reductiona/improvement in symptoms (if available) | Follow-up duration |
| Traditional Chinese medicine (n=20) | ||||||||
| Li et al. (2015) [41] | Renal function | 8 g TSF granules TID and ARB BID x 24 weeks | 8 g placebo TID and ARB BID x 24 weeks | WHOQOL-BREF, DQOL | UAER (μg/min) (pre vs post): 105.39±77.29 vs 88.37±108.46, p=0.021 | Yes | -16.1% (UAER) | 6 months |
| 24 h urinary protein (g/24 h) (pre vs post): 1.12±0.75 vs 0.91±0.90, p=0.017 | -18.8% (24 h urinary protein) | |||||||
| Ma et al. (2013) [43] | Renal function | 150 mL ZSTL solution BID x 3 months | 10 mg benazepril QD x 3 months | Radioimmunoassay, ELISA | HbA1c (%) (baseline vs mean change from baseline): 10.68 (8.48, 13.96) vs -4.29 (-5.85, -2.79), p<0.05. | Yes | -40.2% (HbA1c) | 9 months |
| UAER (μg/min) (baseline vs mean change from baseline): 211.52 (164.58, 243.89) vs -106.99 (-121.29, -85.55), p<0.05 | -50.6% (UAER) | |||||||
| SCr (μmol/L) (baseline vs mean change from baseline): 87.17 (70.59, 110.25) vs -3.33 (-11.02, 2.15), p<0.05 | -3.82% (SCr) | |||||||
| CCR (mL/min) (baseline vs mean change from baseline): 139.86 (129.58, 149.52) vs -9.22 (-13.42, -5.82), p <0.05 | -6.59% (CCR) | |||||||
| Wang et al. (2012) [17] | Renal function | T1: TCM granuleb BID x 24 weeks. T2: TCM granuleb BID and 10 mg benazepril QD x 24 weeks. | 10 mg benazepril QD and TCM placebo TID x 24 weeks | MDRD study equation, TCM assessing sheets | eGFR (mL/min/1.73 m2) (pre vs post): T1: 45.26±10.12 vs 48.46±15.90, p<0.05. T2: 44.68±9.82 vs 48.31±17.50, p<0.05. | Yes | 7.07% (eGFR; T1), 8.12% (eGFR; T2) | 6 months |
| 24 h proteinuria (mg/24 h) (pre vs post): T1: 725.98 vs 990.00, p<0.05. T2: 590.00 vs 453.50, p<0.05 | 36.4% (proteinuria; T1), -21.1% (proteinuria; T2) | |||||||
| Urinary albumin/creatinine (mg/gCr) (pre vs post): T2: 0.30 vs 0.22, p<0.05 | -26.7% (urinary albumin/creatinine; T2) | |||||||
| Hb (g/L) (pre vs post): T1: 127.31±18.47 vs 129.57±21.82, p<0.05 | 17.8% (Hb; T1) | |||||||
| Yu et al. (2017) [50] | Renal function | Acupuncture at Li4, ST36 and K13 acupoint QD x 3 months | Sham acupuncture QD x 3 months | NI | SCr levels (mg/dL) (T vs C): baseline: 1.45 vs 1.67, p=0.1298. Post-intervention: 1.41 vs 1.65, p=0.0489. 3-month follow-up: 1.32 vs 1.81, p=0.0467 | Yes | -2.76% (SCr; pre vs post), -9.00% (SCr; pre- vs 3 months follow-up) | 6 months |
| eGFR (mL/min/1.73m2) (T vs C): Baseline: 51.85 vs 42.50, p=0.0855. Post-intervention: 54.50 vs 43.60, p=0.0470. 3-month follow-up: 59.90 vs 40.80, p=0.0191 | 5.11% (eGFR; pre vs post), 15.5% (eGFR; pre-intervention vs 3 months follow-up) | |||||||
| hs-CRP (mg/dL) (T vs C): Baseline: 1.10 vs 0.79, p=0.4361. Post-intervention: 0.80 vs 0.90, p=0.8773 | -27.3% (hs-CRP pre vs post) | |||||||
| Zhao et al. (2020) [52] | Renal function | Herbal granulec TID x 6 months | Placebo granules x TID 6 months | Dye-binding method, Cerebrospinal fluid protein test kit, Determiner L CRE kit | SCr (μmol/L) (pre vs weeks 16, 20 and 24): 148.42±35.90 vs 130.19±29.79, 130.08±30.57, 130.78±32.55, p<0.05 | Yes | -12.3% (SCr; pre vs 16 weeks), -12.4% (SCr; pre vs 20 weeks), -11.9% (SCr; pre vs 24 weeks) | 6 months |
| Xiang et al. (2016) [47] | Renal function | QDDHG tablets BID and ARB (minimum dosage) x 12 weeks | ARB tablets (minimum dosage) | Guidelines for clinical research of Chinese medicine | Albumin (mg/24h) (within treatment group, baseline vs 4 vs 8 vs 12 week): 85.30 (66.00, 176.30) vs 61.50 (49.00, 110.20), p<0.05 vs 51.00 (37.00, 90.00), p<0.05 vs 41.40 (29.00, 68.00), p<0.05 | Yes | -27.9% (Albumin; 4 weeks), -40.2% (Albumin; 8 weeks), -43.9% (Albumin; 12 weeks) | 3 months |
| Proteinuria (g/24h) (within treatment group, baseline vs 4 vs 8 vs 12 week): 0.20 (0.10, 0.30) vs 0.10 (0.10, 0.20), p<0.05 vs 0.10 (0.10, 0.20), p<0.05 vs 0.10 (0.10, 0.20), p<0.05 | -50% (Proteinuria; 4, 8, 12 weeks) | |||||||
| Albumin/creatinine (mg/mol) (within treatment group, baseline vs 4 vs 8 vs 12 week): 20.70 (11.00, 30.50) vs 16.30 (8.10, 25.00), p<0.05 vs 15.00 (7.20, 20.60), p<0.05 vs 10.10 (5.60, 17.00), p<0.05 | -21.3% (albumin/creatinine; 4 weeks), -27.5% (albumin/creatinine; 8 weeks), -51.2% (albumin/creatinine; 12 weeks) | |||||||
| Xu et al. (2016) [49] | Renal function | 500 mg GS-Rb1 (ginseng extract) QD x 6 months | Placebo tablets QD x 6 months | ELISA | Creatinine and urea level (T vs C): 6 months, p<0.01. 12 months, p<0.01 | Yes | - | 12 months |
| Oxidative stress markers (T vs C): 6 months, p<0.01. 12 months, p<0.05 | ||||||||
| TNF-a level (T vs C): 6 months, p<0.05 | ||||||||
| Chen et al. (2013) [37] | Proteinuria | 9.6 g of Shenqi particle TID x 48 weeks | Routine care | MDRD study equation | Proteinuria (g/d) (pre vs post): 5.34±2.74 vs 2.04±2.15, p<0.001 | Yes | -61.8% (proteinuria) | 12 months |
| eGFR (mL/min/1.73 m2) (pre vs post): 84.6±27.0 vs 100.7±37.5, p=0.001 | 19.0% (eGFR) | |||||||
| Ge et al. (2013) [39] | Proteinuria | 40 mg TwHF TID x 3 months, 20 mg TwHF TID x 3 months. | 160 mg valsartan capsules QD x 6 months | Trichloroacetic acid method, Jaffe reaction, MDRD study equation, high-performance liquid chromatography | Urinary protein (g/24 h) (pre vs 1 month, pre vs 3 months, pre vs 6 months): 4.99±2.25 vs 3.23±2.57, p<0.01. 4.99±2.25 vs 2.83±1.57, p<0.01. 4.99±2.25 vs 2.99±1.81, p<0.01 | Yes | -35.3% (urinary protein; 1 months), -43.3% (urinary protein; 3 months), -40.1% (urinary protein; 6 months) | 6 months |
| eGFR (mL/min/1.73 m2) (pre vs 6 months): 43.07±21.65 vs 38.71±23.66, p<0.05 | -10.1% (eGFR; 6 months) | |||||||
| Li et al. (2020) [42] | Proteinuria | Huangkui capsule TID x 12 months | Losartan potassium tablet QD and placebo capsules TIW x 12 months | NI | Proteinuria (mg/24 h) (pre vs post): 1238.9±667.4 vs 1008.8±1104.7, p<0.001 | Yes | -18.6% (proteinuria) | 12 months |
| Zhang et al. (2014) [51] | Proteinuria | T1: Huangkui capsule TID x 6 months. T2: Huangkui capsule TID and Losartan potassium tablet QD x 6 months. | Losartan tablet potassium QD x 6 months | Biuret method, sarcosine oxidase assay | Proteinuria within T1 (pre vs 12 vs 24 weeks): 1045±420 vs 762±533, p<0.001 vs 537±409, p<0.001 | Yes | T1: -27.1% (pre vs 12 weeks), -48.6% (pre vs 24 weeks) | 6 months |
| Proteinuria within T2 (pre vs 12 vs 24 weeks):1073±439 vs 783±658, p<0.001 vs 529±509, p<0.001. | T2: -27.0% (pre vs 12 weeks), -50.7% (pre vs 24 weeks). | |||||||
| Xiong et al. (2020) [48] | Proteinuria | 60 mg TWHF and 160 mg valsartan QD x 24 weeks | 160 valsartan QD x 24 weeks | CKD-EPI equation | Proteinuria (g/24 h) (T vs C, PP analysis): 3.16±0.62 vs 4.28±0.85, p<0.001 | Yes | PP: -26.2% (proteinuria) | 6 months |
| Serum albumin (g/L) (T vs C, PP analysis): 37.65±4.31 vs 33.59±4.56, p<0.001 | PP: 12.1% (serum albumin) | |||||||
| Proteinuria (g/24 h) (T vs C, ITT analysis): 3.36±0.83 vs 4.52±1.06; p<0.001 | ITT: -25.7% (proteinuria) | |||||||
| Serum albumin (g/L) (T vs C, ITT analysis): 36.91±4.42 vs 34.67±4.75, p=0.008 | ITT: 6.46% (serum albumin) | |||||||
| Che-yi et al. (2005) [36] | Uremic pruritus | Acupuncture at Quchi (L11) acupoint TIW x 1 month | Sham acupuncture TIW x 1 month | Validated questionnaire | Pruritus scores (pre vs post vs 3 months follow-up): 38.2±4.8 vs 17.3±5.5 vs 16.5±4.9, p<0.001 | Yes | -54.7% (pruritus scores; pre- vs post-intervention), -56.8% (pruritus scores; pre-intervention vs 3 months follow-up) | 3 months |
| Gao et al. (2002) [38] | Uremic pruritus | Acupuncture at Quchi (L11) and Zusanli (ST 36) acupoint BIW x 1 month | Sham acupuncture BIW x 1 month | NI | Number of patients (complete alleviation vs improvement vs no effect): 24 (70.6%) vs 9 (26.5%) vs 1 (2.9%) | Yes | - | 3 months |
| Nahidi et al. (2018) [7] | Uremic pruritus | 30 minutes of acupuncture, for six weeks, at the following acupoints: Sp6, Sp10, Lv3, Li4, Li11. | 30 minutes of sham acupuncture, for 6 weeks. | VAS | Pruritus scores (pre vs post): 9.87±0.35 vs 3.93±2.85, p<0.001 | Yes | -60.2% (pruritus scores) | 6 weeks |
| Ono et al. (2015) [3] | Fatigue, insomnia, itchiness, and pain | Acupuncture QIW x 2 months | Routine care | VAS, EQ-5D | Headache score (pre vs post): 17.1±26.1 vs 6.2±13.5, p<0.05. | Yes | -63.7% (headache score) | 3 months |
| Blurred vision score (pre vs post): 33.4±32.7 vs 17.0±22.2, p<0.05. | -49.1% (blurred vision score) | |||||||
| Dizziness score (pre vs post): 13.0±21.4 vs 1.4±6.3, p<0.05. | -89.2% (dizziness score) | |||||||
| Ear buzzing (pre vs post): 17.9±27.2 vs 8.0±14.7, p<0.05 | -55.3% (ear buzzing) | |||||||
| Cervical pain (pre vs post): 37.7±39.1 vs 25.3±29.7, p<0.05 | -32.9% (cervical pain) | |||||||
| Stiff shoulders (pre vs post): 29.9±28.6 vs 12.5±21.6, p<0.05 | -58.2% (stiff shoulders) | |||||||
| Back pain (pre vs post): 38.5±33.7 vs 9.3±18.1, p<0.05 | -58.2% (back pain) | |||||||
| Lower limb pain (pre vs post): 29.4±36.4 vs 17.1±23.3, p<0.05 | -41.8% (lower limb pain) | |||||||
| Numbness in upper limb (pre vs post): 18.9±30.4 vs 4.0±29.5, p<0.05 | -78.8% (numbness in upper limb) | |||||||
| Numbness in lower limb (pre vs post): 21.9±34.9 vs 11.0±26.2, p<0.05 | -49.8% (numbness in lower limb) | |||||||
| Itchiness (pre vs post): 38.7±40.7 vs 29.3±31.5, p<0.05 | -24.3% (itchiness) | |||||||
| Difficulty in sleeping (pre vs post): 34.8±36.9 vs 12.8±22.5, p<0.05 | -63.2% (difficulty in sleeping) | |||||||
| Utility in treatment group (pre vs post): 0.66±0.15 vs 0.76±0.17, p<0.05 | 15.2% (utility) | |||||||
| Su et al. (2009) [44] | QoL | Infrared stimulation of Qihai (RN6), Kuamyuan (RN4) and Chungchi (RN3) TIW x 3 months | Heat pad therapy to acupoints TIW x 3 months | Heart rate variability analyser, WHOQOL-BREF questionnaire | LF activity (pre vs post): 49.99±79.08 vs 131.71±214.36, p=0.01 | Yes | 163% (LF activity) | 3 months |
| Fatigue index (pre vs post): 133.90±20.43 vs 121.71±32.68, p=0.02 | -9.10% (fatigue index) | |||||||
| Psychological domain (pre vs post): 18.16±4.30 vs 19.39±0.72, p=0.02 | 6.77% (psychological domain) | |||||||
| Environmental domain (pre vs post): 29.87±4.04 vs 32.00±4.85, p=0.00. | 7.13% (environmental) | |||||||
| Wang et al. (2019) [45] | Wnt/β-catenin signaling pathway | Qingshen granules TID x 3 months | Placebo granules TID x 3 months | ELISA | Effective rates of TCM symptom (T vs C): 80% vs 60%, p=0.024 | Yes | - | 3 months |
| eGFR (mL/min) (T vs C): 15.9±3.2 vs 14.0±4.0, p=0.019 | 17.8% (eGFR) | |||||||
| HIF-1𝛼 (ng/mL) (T vs C): 0.66±0.16 vs 1.39±0.17, p≤0.001 | -61.4% (HIF-1𝛼) | |||||||
| Wnt1 (pg/mL) (T vs C): 314.2±85.8 vs 382.8±85.3, p=0.001 | -16.9% (Wnt1) | |||||||
| 𝛽-catenin (pg/mL) (T vs C): 416.5±13.6 vs 462.1±15.1, p ≤0.001 | -10.0% (𝛽-catenin) | |||||||
| 𝛼-SMA (KU/L) (T vs C): 20.5±3.1 vs 23.5±4.1, p≤0.001 | -20.8% (𝛼-SMA) | |||||||
| E-cadherin (ng/mL) (T vs C): 2166.9±398.6 vs 2370.7±468.0, p=0.039 | -15.1% (E-cadherin) | |||||||
| Wang et al. (2020) [46] | Immune function | Qingshen granules TID x 3 months | Routine care | Flow cytometry, ELISA | CD4+/CD8+ T cell (pre vs post): 1.98±0.86 vs 1.58±0.72, p<0.05. | Yes | -20.2% (CD4+/CD8+ T cell) | 3 months |
| Th17 cell (pre vs post): 2.51±1.05 vs 1.70±0.83, p<0.01. | -32.3% (Th17) | |||||||
| NF-κB p65 (pre vs post): 36.84±12.96 vs 24.86±1.97, p<0.05 | -32.5% (NF-κB p65) | |||||||
| IL-17 (pre vs post): 28.62±13.53 vs 19.78±12.25, p<0.05 | -30.9% (IL-17) | |||||||
| IL-6 (pre vs post): 77.13±20.54 vs 58.42±18.25, p<0.05 | -24.3% (IL-6) | |||||||
| TNF-α (pre vs post): 110.34±23.76 vs 75.49±22.80, p<0.01 | -31.6% (TNF-α) | |||||||
| TRAF6 (pre vs post): 4.94±1.82 vs 2.85±1.53, p<0.01 | -42.3% (TRAF6) | |||||||
| FN (pre vs post): 93.42±20.36 vs 62.86±19.35, p<0.01 | -32.7% (FN) | |||||||
| Col-IV (pre vs post): 36.85±14.58 vs 24.36±13.36, p<0.01 | -33.9% (Col-IV) | |||||||
| Total effective rate (T vs C): 79.41% vs 67.12%, p<0.05. | - | |||||||
| Li et al. (2009) [40] | Vascular endothelial function | TBN tablets (gingko extract) TID x 8 weeks | Routine care | Chemical colorimeter, Radioimmunoassay, ELISA, Siemens Sequoia 512 color Doppler ultrasonography | UAER (μg/min) (pre vs post): 153.30±63.28 vs 85.15±36.82, p<0.01 | Yes | -44.5% (UAER) | 3 months |
| SCr (μmol/L) (pre vs post): 120.76±17.83 vs 105.67±18.13, p<0.01 | -12.5% (SCr) | |||||||
| NO (μmol/L) (pre vs post): 50.16±24.64 vs 70.65±28.71, p<0.01 | 40.8% (NO) | |||||||
| vWF (%) (pre vs post): 182.05±64.13 vs 128.56±48.98, p<0.01 | -29.4% (vWF) | |||||||
| BAID responsive change (%) (pre vs post): 4.91±2.31 vs 6.78±3.89, p<0.01 | 38.1% (BAID responsive change) | |||||||
| Ayurveda (n=6) | ||||||||
| Alam et al. (2020) [53] | Renal function | Sativa oil QD and alpha-keto amino acid tablets TID x 3 months | Alpha-keto amino acid tablets TID x 3 months | Hemogram, renal function test, serum electrolyte test | Hb% (g/dL) (pre vs post): 8.84±1.31 vs 10.24±1.10, p<0.001 | Yes | 15.8% (Hb%) | 3 months |
| 24-h TUV (mL/day) (pre vs post): 1250.69±303.74 vs 1660.14±258.78, p<0.001 | 32.7% (TUV) | |||||||
| eGFR (mL/min) (pre vs post): 22.71±7.28 vs 42.42±17.38, p<0.001 | 86.8% (eGFR) | |||||||
| Fallahzadeh et al. (2012) [54] | Renal function | 140 mg silymarin tablet QD x 3 months | Placebo tablet QD x 3 months | Jaffé method, ELISA MDA assay, MDRD study equation, nephelometry, high-performance liquid chromatography, mercury sphygmomanometer | Urinary TNF-α (pg/mg) (change from baseline): -3.45 (-5.44 to -1.46), p<0.05 | Yes | - | 2 months |
| Urinary MDA (nmol/mg) (change from baseline): -1.5 (-2.87 to -0.13, p<0.05 | ||||||||
| Serum MDA (μmol/L) (change from baseline): -3.43 (-6.02 to -0.83), p<0.05 | ||||||||
| Hoseini et al. (2019) [55] | Renal function | Camel milk BID x 3 months | Routine care | MDRD | eGFR (pre vs post): 26.9±7.39 vs 31.45±8.99, p=0.001 | Yes | 16.9% (eGFR) | 3 months |
| SCr levels (pre vs post): 2.58±0.71 vs 2.2±0.48, p=0.01 | -14.7% (SCr) | |||||||
| BUN (pre vs post): 60.31±22.61 vs 44.38±14.29, p=0.0001 | -26.4% (BUN) | |||||||
| Khajehdehi et al. (2011) [56] | Renal function | 140 mg silymarin TID x 3 months | Placebo tablet TID x 3 months | ELISA | Proteinuria (mg/24h) (pre vs post, patients with type 2 diabetic nephropathy): 4328.7±3038.2 vs 2354.7±1800.1, p=0.001 | Yes | -45.6% (proteinuria) | 2 months |
| IL-8 (pg/mL) (pre vs post, patients with type 2 diabetic nephropathy): 99.1±97.9 vs 43.6±55.0, p=0.002 | -56.0% (IL-8) | |||||||
| TGF-β (pg/mL) (pre vs post, patients with overt type 2 diabetic nephropathy): 522.3±189.2 vs 397.3±55.2, p=0.006 | -23.9% (TGB-β) | |||||||
| IL-8 (pg/mL) (pre vs post, patients with overt type 2 diabetic nephropathy): 41.4±50.3 vs 30.6±75.2, p=0.02 | -26.1% (IL-8) | |||||||
| Makhlough et al. (2010) [57] | Uremic pruritus | 0.03% capsaicin ointment QID x 4 weeks | Placebo ointment QID x 4 weeks | Uremic pruritus scoring questionnaire by Duo | Pruritus score (T vs C): 2.5±2.5 vs 7.2±5.5, p<0.05 | Yes | -84.3% (pruritus score) | |
| Pingali et al. (2020) [58] | Hyperuricemia | T1:500 mg of beleric capsule taken QD. T2: 1000 mg of beleric capsule taken QD | 40 mg of Febuxostat taken QD | Jaffe method, MDRD Study equation, Salbutamol challenge test, Ellman’s method, Chrono-log light transmittance aggregometry, Spectrometry, Colorimetric detection with Griess reagents | SCr (pre vs post): group B: 1.86±0.32 vs 1.64±0.29, p≤0.005. Group C: 2.06±0.26 vs 1.56±0.24, p≤0.0001 | Yes | -11.70%±9.00 (SCr, group B), -24.42%±8.14 (SCr, group C). | 6 months |
| eGFR (pre vs post): group B: 39.13±6.57 vs 45.96±11.14, p≤0.005. Group C: 34.78±5.34 vs 48.93±11.46, p≤0.0001 | 16.96%±14.87 (eGFR, group B), 40.39%±20.98 (eGFR, group C) | |||||||
| Serum uric acid (pre vs post): Group B:8.10±0.67 vs 6.46±0.34, p≤0.0001. Group C: 8.54±0.64 vs 5.63±0.37, p≤0.0001 | 19.84%±6.43 (serum uric acid, group B), 33.88%±4.95 (serum uric acid, group C) | |||||||
| Naturopathy (n=5) | ||||||||
| Khan et al. (2014) [60] | Malnutrition | Alpha-keto amino acid tablets TID x 3 months | Placebo tablets TID x 3 months | Blood tests | Hb% (g/dL) (T vs C): 9.39±0.87 vs 8.91±1.48, p<0.05 | Yes | 19.8% (Hb%) | 3 months |
| FBG (mg/dL) (T vs C): 104.00±8.46 vs 113.78±14.31, p<0.001 | -20.8% (FBG) | |||||||
| Blood urea (mg/dL) (T vs C): 66.07±19.29 vs 79.78±24.79, p<0.001 | -38.1% (blood urea) | |||||||
| SCr (mg/dL) (T vs C): 2.83±1.10 vs 3.33±1.37, p<0.05 | -39.5% (SCr) | |||||||
| 24 h TUP (g/day) (T vs C): 2.06±0.61 vs 2.43±0.97, p<0.01 | -38.3% (TUP) | |||||||
| 24 Hour TUV (mL/day) (T vs C): 1943.23±204.1 vs 1736.76±176.04, p<0.001 | 33.3% (TUV) | |||||||
| GFR (mL/min) (T vs C): 29.4±3.68 vs 23.3±1.63, p<0.001 | 49.2% (GFR) | |||||||
| Prakash et al. (2004) [61] | Malnutrition | Keto amino acid tablets QD x 9 months | Placebo tablets QD x 9 months | 99mTc-DTPA plasma sample method | GFR (mL/min/ 1.73 m2) (pre vs post within C): 28.6±17.6 vs 22.5±15.9, p=0.015. | Progress of renal failure prevented. | - | 9 months |
| Serum total proteins (g%) (pre vs post within C): 7.04±0.66 vs 6.56±0.83, p=0.038 | ||||||||
| Mid-arm circumference (cm) (pre vs post within C): 28.0±4.4 vs 27.3±4.8, p=0.048 | ||||||||
| Sedaghattalab et al. (2021) [62] | Inflammation | Watercress extract QD x 1 month | Placebo extract QD x 1 month | Blood tests, TBA reaction assay, Colorimetric kits, Spectrophotometer | BUN (mg/dL) (pre vs post): 40.6±11.2 vs 34.6±15.1, p<0.04. | Yes | -14.8% (BUN) | 1 month |
| Calcium (mg/dL) (pre vs post): 8.8±1.32 vs 10.4±2, p<0.001 | 18.1% (calcium) | |||||||
| Total oxidant status (μM) (pre vs post): 11.3±3.3 vs 6.9±2.4, p<0.001 | -38.9% (total oxidant status) | |||||||
| Sulfhydryl protein (mmol/L) (pre vs post): 13.1±5.3 vs 7.4±4.3, p<0.001 | -43.5% (sulfhydryl protein) | |||||||
| MDA (mmol/L) (pre vs post): 1.6±0.13 vs 0.42±0.27, p<0.001 | -73.8% (MDA) | |||||||
| Superoxide dismutase (U/mL) (pre vs post): 29.3±6.3 vs 37.1±8.4, p<0.001 | 26.6% (superoxide dismutase) | |||||||
| Zare et al. (2019) [63] | Inflammation | Garlic extract tablets TIW x 2 months | Placebo tablets TIW x 2 months | Human homocysteine kits, ELISA | IL-6 (pg/mL) (pre vs post): 2.2 (0.8, 6.4) vs 0.7 (0.6, 1.2), p<0.001 | Yes | -68.2% (IL-6) | 2 months |
| CRP (mg/L) (pre vs post): 13.0 (5.0, 14.0) vs 2.0 (1.0, 9.0), p<0.001 | -84.6% (CRP) | |||||||
| ESR (mm) (pre vs post): 50.7±28.5 vs 35.4±21.7, p=0.021. | -30.2% (ESR) | |||||||
| Boldaji et al. (2019) [59] | Hypertension, stress, and inflammation | Pomegranate juice TIW x 2 months | Routine care | Mini nutritional assessment | MDA (μmol L-1) (pre vs post): 0.88±0.01vs 0.77±0.01, p<0.001 | Yes | -12.5% (MDA) | 2 months |
| Total antioxidant capacity (mmol L-1) (pre vs post): 0.40±0.08vs 0.49±0.11, p<0.001 | 22.5% (total antioxidant capacity) | |||||||
| IL-6 (ng L-1) (pre vs post): 3.00±1.48 vs 2.09±1.25, p<0.0001 | -30.3% (IL-6) | |||||||
| Homeopathy (n=2) | ||||||||
| Cavalcanti et al. (2003) [16] | Uremic pruritus | Homeopathic verum medicationd administered | Placebo medication administered | Validated scale | Pruritus score (pre vs 15 vs 30 vs 45 vs 60 days): 65±25 vs 46±29, p=0.002 vs 41±30, p=0.002 vs 42±29, p=0.002 vs 38±33, p=0.004 | Yes | -29.2% (pruritus score, pre vs 15 days), -36.9% (pruritus score, pre vs 30 days), -35.4% (pruritus score, pre vs 45 days), -41.5% (pruritus score, pre vs 60 days) | 60 days |
| Silveira et al. (2019) [64] | Renal function | Brazilian green propolis pills BID x 3 months | Placebo pills BID x 3 months | Immunoturbidimetry, ELISA | Proteinuria (mg/24 h) (T vs C, baseline vs 12 months): 695 (95% CI, 483 to 999) vs. 1403 (95% CI, 1031 to 1909); p=0.004 | Yes | -27.6% (proteinuria) | 12 months |