Systematic review on efficacy of alprostadil combined with losartan in treatment of diabetic nephropathy

QI Jia; CHEN Lun; ZHANG Yu-feng

doi:10.3969/j.issn.1002-266X.2015.28.004

Abstract：Objective To systematically evaluate the clinical efficacy of alprostadil combined with losartan in the treatment of diabetic nephropathy ( DN) .Methods Major Chinese database and foreign language database from the incep-tion of each database up to 30th January 2015 were electronically searched for the randomized clinical trials of alprostadil combined with losartan in the treatment of DN.Conventional hypoglycemic therapy combined with alprostadil and losartan was considered as the treatment group, conventional treatment combined with alprostadil or losartan was taken as the control group.The Cochrane risk of bias tool was used to assess the risk of bias.We assessed the quality of included studies using the Jadad rating scale.If the data included could not be used in the meta-analysis, then we used descriptive analysis;if the data included could be used in the meta-analysis, then the Cochrane Collaboration′s RevMan5.3 software was used for me-ta-analysis.Results Eight studies were included and they contained 584 DN patients.The total effective rate, 24-hour u-rinary albumin, 24-hour urinaryβ2 microglobulin and urinary albumin excretion rate of the treatment group were better than those of the control group (all P<0.05).No significant difference was found in the creatinine, urea nitrogen, creatinine clearance rate, systolic blood pressure and fasting blood glucose between these two groups (all P>0.05).All studies in-cluded did not report any adverse reactions.Conclusion Alprostadil combined with losartan in the treatment of diabetic nephropathy can significantly improve the clinical curative effect, reduce urinary protein and has good safety.