Rheum officinale (a traditional Chinese medicine) for chronic kidney disease

Han Wang; Hongxian Song; Jirong Yue; Jun Li; Yan Bin Hou; Jue Lin Deng

doi:10.1002/14651858.CD008000.pub2

Rheum officinale (una medicina tradicional china) para la nefropatía crónica

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Referencias de los estudios incluidos en esta revisión

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Referencias de los estudios excluidos de esta revisión

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Referencias de los estudios en espera de evaluación

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Referencias de otras versiones publicadas de esta revisión

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estudios excluidos
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otras referencias

Wang H, Yue J, Li J, Hou YB, Deng JL. Rheum officinale (a Chinese medicinal herb) for chronic kidney disease. Cochrane Database of Systematic Reviews 2009, Issue 4. [DOI: 10.1002/14651858.CD008000]

Characteristics of studies

Characteristics of included studies [ordered by study ID]

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Gao 2004

Methods	Study design: Parallel RCT
Participants	Inclusion criteria Country: China Patients with CKD; SCr of 178 μmol/L to 707 μmol/L Duration of CKD: 4 months to 25 years Number: Treatment group (15); control group (15) Age (range): 26 to 80 years Sex (M/F): 14/16 Exclusion criteria: NS
Interventions	Treatment group Rheum officinale Dose: 6 to 15 g/d Jinshuibao (Chinese medicinal herbs) Dose: 6 pills 3 times/day Duration: 4 weeks; oral administration Dietary control and symptomatic treatment Control group Jinshuibao Dose: 6 pills 3 times/day Duration: 4 weeks; oral administration Dietary control and symptomatic treatment
Outcomes	CrCl (mL/min) SCr (µmol/L) BUN (mmol/L)
Notes
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No information provided
Allocation concealment (selection bias)	Unclear risk	No information provided
Blinding (performance bias and detection bias) All outcomes	Unclear risk	No information provided
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data
Selective reporting (reporting bias)	Unclear risk	Insufficient information to permit judgement
Other bias	Unclear risk	Insufficient information to assess whether other risks of bias exist

Ge 1994

Methods	Study design: parallel RCT
Participants	Inclusion criteria Country: China DKD patients with azotaemia Duration of CKD: 4 months to 25 years Number: Treatment group (24); control group (22) Age (mean ± SD): 54.9 ± 8.3 years Sex (M/F): 16/30 Exclusion criteria Acute infection; heart failure; diabetic ketoacidosis
Interventions	Treatment group Rheum officinale (prepared Radix et Rhizoma Rhei) Dose: 3 to 8 g/day Duration: 6 months; oral administration Control group Captopril Dose: 25 to 75 mg/day Duration: 6 months; oral administration Co‐interventions Dietary control; glycaemic control; symptomatic control
Outcomes	CrCl (mL/min) BUN (mmol/L)
Notes
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No information provided
Allocation concealment (selection bias)	Unclear risk	No information provided
Blinding (performance bias and detection bias) All outcomes	Unclear risk	No information provided
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data
Selective reporting (reporting bias)	Unclear risk	Insufficient information to permit judgement
Other bias	Low risk	Baseline balance; no other bias detected

Ji 1993

Methods	Study design: Parallel RCT
Participants	Inclusion criteria Country: China Patients with CKD requiring HD; CrCl < 10 mL/min Number: Treatment group (22); control group (20) Age (mean ± SD): 41.2 ± 15.2 years Sex (M/F): 25/17 Exclusion criteria: NS
Interventions	Treatment group Baoshen pill (Rheum officinale extract) Dose: Initial dose (1 g/day); maintenance dose (6 to 9 g/day) Duration: 3 to 7 months; oral administration Control group Routine treatment Dietary control and symptomatic management Duration: 3 to 7 months Co‐interventions HD, dietary control, symptomatic treatment
Outcomes	SCr (µmol/L) BUN (mmol/L)
Notes
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No information provided
Allocation concealment (selection bias)	Unclear risk	No information provided
Blinding (performance bias and detection bias) All outcomes	Unclear risk	No information provided
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data
Selective reporting (reporting bias)	Unclear risk	Insufficient information to permit judgement
Other bias	Low risk	Baseline balance, we did not find any other bias

Liu 2001a

Methods	Study design: Parallel RCT
Participants	Inclusion criteria Country: China Duration of CKD: 79 ± 39 months Number: Treatment group (22); control group (20) Age range: 24 to 67 years Sex (M/F): 28/14 Exclusion criteria: NS
Interventions	Treatment group Rheum officinale capsule (Radix et Rhizoma Rhei) Dose: 6 g/day, oral administration Routine treatment Dietary control, symptomatic treatment Duration: 28 months Control group Routine treatment Dietary control, symptomatic treatment Duration: 28 months
Outcomes	Incidence of ESKD (N) SCr (µmol/L)
Notes	ESKD definition: SCr up to 707 µmol/L
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No information provided
Allocation concealment (selection bias)	Unclear risk	No information provided
Blinding (performance bias and detection bias) All outcomes	Unclear risk	No information provided
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data
Selective reporting (reporting bias)	Low risk	The study protocol was not available but the published reports included primary outcomes for this review
Other bias	Unclear risk	Insufficient information to assess whether other important risks of bias exist

Shen 2008

Methods	Study design: Parallel RCT
Participants	Inclusion criteria Country: China Uraemia not requiring HD: SCr 442 to 707 µmol/L; patients without acute infection, inflammation, rheumatism, cancer or liver disease; antioxidant drugs not used in the last month Duration of CKD: > 3 months Number: Number (treatment/control): 24/23 Age (mean ± SD): NS Sex (M/F): 24/23 Exclusion criteria: NS
Interventions	Treatment group Rheum officinale (Radix et Rhizoma Rhei) Dose: 10 g/day; oral administration Routine treatment Dietary control, symptomatic treatment Duration: 2 months Control group Routine treatment Dietary control, symptomatic treatment Duration: 2 months
Outcomes	hs‐CRP (mg/L) IL‐6 (pg/mL) MDA (nmol/L) TNF‐alpha (pg/mL) GSHPx (U/L)
Notes	No outcome data were available
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No information provided
Allocation concealment (selection bias)	Unclear risk	No information provided
Blinding (performance bias and detection bias) All outcomes	Unclear risk	No information provided
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data
Selective reporting (reporting bias)	Unclear risk	Insufficient information to permit judgement
Other bias	Unclear risk	Insufficient information to assess whether an important risk of bias exists

Song 2000

Methods	Study design: Parallel RCT
Participants	Inclusion criteria Country: China CKD patients; SCr between 176.8 and 530.4 µmol/L Duration of CKD: 30 to 160 days Number: Treatment group (48); control group (51) Age (range): 16 to 75 years Sex (M/F): 66/33 Exclusion criteria: NS
Interventions	Treatment group Rheum officinale (decoction from prepared Radix et Rhizoma Rhei) Dose: initial dose (6 to 9 g/day); maintenance dose (12 to 24 g/day); oral administration Captopril Dose: 12.5 to 25 mg, 2 or 3 times/day Routine treatment Dietary control, symptomatic treatment Duration: 3 months Control group Captopril 12.5 to 25 mg, 2 or 3 times/day; oral administration Routine treatment Dietary control, symptomatic treatment Duration: 3 months
Outcomes	SCr (µmol/L) Proteinuria (g/24 h)
Notes
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No information provided
Allocation concealment (selection bias)	Unclear risk	No information provided
Blinding (performance bias and detection bias) All outcomes	Unclear risk	No information provided
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data
Selective reporting (reporting bias)	Unclear risk	Insufficient information to permit judgement
Other bias	Unclear risk	Insufficient information to assess risk of bias

Zhang 1990

Methods	Study design: Parallel RCT
Participants	Inclusion criteria Country: China CKD patients; Mean SCr 344.8 ± 114.0 µmol/L Number: Treatment group 1 (11); Treatment group 2 (10); captopril (9) Age range (mean ± SD): 25 to 67 years (40.7 ± 13.4 years) Sex (M/F): 24/6 Exclusion criteria Infection; bleeding; dehydration; severe hypertension; acidosis
Interventions	Treatment group 1 Baoshen pill (Rheum officinale extract) Dose: Initial dose (1 g/day); maintenance dose (6 to 9 g/day); oral administration Routine treatment Dietary control, symptomatic treatment Duration: 6 to 22 months Treatment group 2 Baoshen Pill (Rheum officinale extract) Dose: Initial dose (1 g/day); maintenance dose (6 to 9 g/day) Captopril Dose: 25 mg, 3 times/day; oral administration Routine treatment Dietary control, symptomatic treatment Duration: 6 to 22 months Control group Captopril 25 mg, 3 times/day; oral administration Routine treatment Dietary control, symptomatic treatment Duration: 6 to 22 months
Outcomes	BUN (mmol/L) Quality of life: full and part‐time working capacity (N)
Notes
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No information provided
Allocation concealment (selection bias)	Unclear risk	No information provided
Blinding (performance bias and detection bias) All outcomes	Unclear risk	No information provided
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data
Selective reporting (reporting bias)	Low risk	The study protocol was available and all specified outcomes were reported
Other bias	Unclear risk	Insufficient information to assess if risk of bias exists

Zhang 1993a

Methods	Study design: Parallel RCT
Participants	Inclusion criteria Country: China CKD patients; mean SCr 328.0 ± 84.0 µmol/L Number: Treatment group (106); control group (92) Age (mean ± SD): 39.8 ± 12.6 years Sex (M/F): 128/70 Exclusion criteria: NS
Interventions	Treatment group Baoshen Pill (Rheum officinale extract) Dose: 6.2 ± 0.5 g/day; oral administration Routine treatment Dietary control, symptomatic treatment Duration: 6 to 46 months Control group Routine treatment Dietary control, symptomatic treatment Duration: 6 to 46 months
Outcomes	HDL (mmol/L) LDL (mmol/L) VLDL (mmol/L) TG (mmol/L)
Notes	No outcomes data were available
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No information provided
Allocation concealment (selection bias)	Unclear risk	No information provided
Blinding (performance bias and detection bias) All outcomes	Unclear risk	No information provided
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Incomplete outcome data may exist
Selective reporting (reporting bias)	Unclear risk	Insufficient information to permit judgement
Other bias	Unclear risk	Insufficient information to assess whether an important risk of bias exists

Zhang 1993b

Methods	Study design: Parallel RCT
Participants	Inclusion criteria Country: China CKD patients; SCr range 221.0 to 486.2 µmol/L (328.0 ± 83.1 µmol/L) Number: Treatment group 1 (49); treatment group 2 (51); control group (48) Age (mean ± SD): 43.4 ± 13.8 years Sex (M/F): 96/52 Exclusion criteria Infection; bleeding; dehydration; severe hypertension; acidosis
Interventions	Treatment group 1 Baoshen pill (Rheum officinale extract) Dose: Initial dose (1 g/day); maintenance dose (6.2 ± 1.5 g/day) Routine treatment Dietary control, symptomatic treatment Duration: 6 to 48 months Treatment group 2 Baoshen Pill (Rheum officinale extract) Dose: Initial dose (1 g/day); maintenance dose (5.8 ± 2.9 g/day) Captopril Dose: 75 mg, 4 times/day; oral administration Routine treatment Dietary control, symptomatic treatment Duration: 6 to 48 months Control group Routine treatment Dietary control, symptomatic treatment Duration: 6 to 48 months
Outcomes	ESKD (N) SCr (µmol/L) BUN (mmol/L)
Notes
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No information provided
Allocation concealment (selection bias)	Unclear risk	No information provided
Blinding (performance bias and detection bias) All outcomes	Unclear risk	No information provided
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Incomplete outcome data may exist
Selective reporting (reporting bias)	Low risk	The study protocol is available and all of the study's pre‐specified outcomes have been reported
Other bias	Unclear risk	Insufficient information to assess whether an important risk of bias exists

BUN ‐ blood urea nitrogen; CKD ‐ chronic kidney disease; CrCl ‐ creatinine clearance; DKD ‐ diabetic kidney disease; ESKD ‐ end‐stage kidney disease; GSHPx ‐ glutathione peroxidase; HD ‐ haemodialysis; HDL ‐ high density lipoprotein; hs‐CPR ‐ high sensitivity C‐reactive protein; IL‐6 ‐ interleukin‐6; LDL ‐ low‐density lipoprotein; MDA ‐ malonaldehyde; NS ‐ not stated; RCT ‐ randomised controlled trial; SCr ‐ serum creatinine; TG ‐ triglyceride; TNF‐alpha: tumour necrosis factor‐alpha; VLDL ‐ very low density lipoprotein

Characteristics of excluded studies [ordered by study ID]

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estudios incluidos
estudios a la espera de clasificación

Study	Reason for exclusion
Chang 2008	Not RCT
Chen 2002	Rheum officinale was a component of compounded Chinese medicinal herbal treatment. It was not possible to determine which herb was the active treatment
Cui 2005	Not RCT
Hu 2006	Not RCT
Hu 2007	Rheum officinale was a component of compounded Chinese medicinal herbal treatment. It was not possible to determine which herb was the active treatment
Huang 2007	Not RCT
Ju 2001	Rheum officinale was a component of compounded Chinese medicinal herbal treatment. It was not possible to determine which herb was the active treatment
Li 1996a	Review article
Li 1996b	Review article
Li 2001	Rheum officinale plus other drugs versus Rheum officinale
Li 2004	Review article
Lin 2004	Rheum officinale plus other drugs versus Rheum officinale
Liu 2001b	Rheum officinale plus other drugs versus Rheum officinale
Liu 2002a	Not RCT
Mao 1997	Not RCT
Ning 2009	Not RCT
Peng 1994	Not RCT
Qiu 1998	Not RCT
Shen 1994	Rheum officinale was a component of compounded Chinese medicinal herbal treatment. It was not possible to determine which herb was the active treatment
Shen 2003	Rheum officinale was a component of compounded Chinese medicinal herbal treatment. It was not possible to determine which herb was the active treatment
Sun 2000	Rheum officinale was a component of compounded Chinese medicinal herbal treatment. It was not possible to determine which herb was the active treatment
Tong 2003	Comparison of Rheum officinale administration
Wang 1997a	Error in randomisation method
Wang 1997b	Rheum officinale plus other drugs versus Rheum officinale
Yin 1998	Rheum officinale was a component of compounded Chinese medicinal herbal treatment. It was not possible to determine which herb was the active treatment
Zhang 1993c	Not RCT
Zhang 1995	Not RCT
Zou 1999	Not RCT

RCT: randomised controlled trial

Characteristics of studies awaiting assessment [ordered by study ID]

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estudios incluidos
estudios excluidos

Gujrati 2001

Methods	Study design: Parallel RCT
Participants	Inclusion criteria Country: India Mild to moderate stable chronic renal failure Number: Treatment 1 (10); treatment 2 (14); treatment 3 (10); control (20) Exclusion criteria: NS
Interventions	Treatment group 1 Rhubarb Treatment group 2 Cybe‐R Treatment group 3 Mahanimb Control group Conventional conservative management
Outcomes	Kidney function
Notes	We were unable to contact the author to obtain more detailed information

NS ‐ not stated; RCT ‐ randomised controlled trial

Data and analyses

Open in table viewer

Comparison 1. Rheum officinale versus no treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Incidence of ESKD Show forest plot	2	124	Risk Ratio (M‐H, Random, 95% CI)	0.53 [0.28, 1.00]
Open in figure viewer Analysis 1.1 Comparison 1 Rheum officinale versus no treatment, Outcome 1 Incidence of ESKD.
2 CrCl Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
Open in figure viewer Analysis 1.2 Comparison 1 Rheum officinale versus no treatment, Outcome 2 CrCl.
3 SCr Show forest plot	4	196	Mean Difference (IV, Random, 95% CI)	‐87.49 [‐139.25, ‐35.72]
Open in figure viewer Analysis 1.3 Comparison 1 Rheum officinale versus no treatment, Outcome 3 SCr.
4 Proteinuria Show forest plot	2	181	Mean Difference (IV, Random, 95% CI)	‐0.35 [‐1.02, 0.31]
Open in figure viewer Analysis 1.4 Comparison 1 Rheum officinale versus no treatment, Outcome 4 Proteinuria.
5 BUN Show forest plot	4	256	Mean Difference (IV, Random, 95% CI)	‐10.83 [‐19.45, ‐2.21]
Open in figure viewer Analysis 1.5 Comparison 1 Rheum officinale versus no treatment, Outcome 5 BUN.

Open in table viewer

Comparison 2. Rheum officinale versus captopril

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 CrCl Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected
Open in figure viewer Analysis 2.1 Comparison 2 Rheum officinale versus captopril, Outcome 1 CrCl.
2 BUN Show forest plot	2	66	Mean Difference (IV, Random, 95% CI)	‐0.28 [‐2.21, 1.65]
Open in figure viewer Analysis 2.2 Comparison 2 Rheum officinale versus captopril, Outcome 2 BUN.
3 Working capacity Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected
Open in figure viewer Analysis 2.3 Comparison 2 Rheum officinale versus captopril, Outcome 3 Working capacity.
3.1 Part‐time working capacity	1		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.2 Full‐time working capacity	1		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

Figure 1

Study flow diagram.

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Figure 2

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies

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Figure 3

Methodological quality summary: review authors' judgements about each methodological quality item for each included study

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Analysis 1.1

Comparison 1 Rheum officinale versus no treatment, Outcome 1 Incidence of ESKD.

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Analysis 1.2

Comparison 1 Rheum officinale versus no treatment, Outcome 2 CrCl.

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Analysis 1.3

Comparison 1 Rheum officinale versus no treatment, Outcome 3 SCr.

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Analysis 1.4

Comparison 1 Rheum officinale versus no treatment, Outcome 4 Proteinuria.

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Analysis 1.5

Comparison 1 Rheum officinale versus no treatment, Outcome 5 BUN.

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Analysis 2.1

Comparison 2 Rheum officinale versus captopril, Outcome 1 CrCl.

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Analysis 2.2

Comparison 2 Rheum officinale versus captopril, Outcome 2 BUN.

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Analysis 2.3

Comparison 2 Rheum officinale versus captopril, Outcome 3 Working capacity.

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Summary of findings for the main comparison. Rheum officinale versus no treatment for chronic kidney disease

Rheum officinale versus no treatment for chronic kidney disease
Patient or population: Patients with chronic kidney disease Settings: China Intervention:Rheum officinale versus no treatment
Outcomes	*Illustrative comparative risks (95% CI)**		Relative effect (95% CI)	No of participants (studies)	Quality of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	Control	Rheum officinale versus no treatment
Incidence of ESKD Analysis method, calculated by regression analysis: 1/SCr versus time. Follow‐up: 6 to 48 months	Study population		RR 0.53 (0.28 to 1)	124 (2 studies)	⊕⊕⊝⊝ Low^1,2
	222 per 1000	118 per 1000 (62 to 222)
	Medium risk population
	378 per 1000	200 per 1000 (106 to 378)
The basis for the assumed risk* (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate Very low quality: We are very uncertain about the estimate
¹ Potential limitations are likely to reduce confidence in the estimate of effect ² Total number of events < 300

Summary of findings for the main comparison. Rheum officinale versus no treatment for chronic kidney disease

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Summary of findings 2. Rheum officinale versus captopril for chronic kidney disease

Rheum officinale versus captopril for chronic kidney disease
Patient or population: Patients chronic kidney disease Settings: China Intervention:Rheum officinale versus captopril
Outcomes	*Illustrative comparative risks (95% CI)**		Relative effect (95% CI)	No of participants (studies)	Quality of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	Control	Rheum officinale versus captopril
Full time working capacity Unclear quality of life scale Follow‐up: 6 to 22 months	Study population		RR 1.02 (0.39 to 2.71)	20 (1 study)	⊕⊕⊝⊝ Low^1,2
	444 per 1000	453 per 1000 (173 to 1000)
	Medium risk population
	444 per 1000	453 per 1000 (173 to 1000)
Part‐time working capacity Unclear quality of life scale Follow‐up: 6 to 22 months	Study population		RR 1.64 (0.38 to 6.98)	20 (1 study)	⊕⊕⊝⊝ Low^3,4
	222 per 1000	364 per 1000 (84 to 1000)
	Medium risk population
	222 per 1000	364 per 1000 (84 to 1000)
The basis for the assumed risk* (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate Very low quality: We are very uncertain about the estimate
¹ Most information from studies at low or unclear risk of bias ² Total population size < 400 ³ Most information from studies at low or unclear risk of bias ⁴ Total population size < 400

Summary of findings 2. Rheum officinale versus captopril for chronic kidney disease

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Comparison 1. Rheum officinale versus no treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Incidence of ESKD Show forest plot	2	124	Risk Ratio (M‐H, Random, 95% CI)	0.53 [0.28, 1.00]

2 CrCl Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

3 SCr Show forest plot	4	196	Mean Difference (IV, Random, 95% CI)	‐87.49 [‐139.25, ‐35.72]

4 Proteinuria Show forest plot	2	181	Mean Difference (IV, Random, 95% CI)	‐0.35 [‐1.02, 0.31]

5 BUN Show forest plot	4	256	Mean Difference (IV, Random, 95% CI)	‐10.83 [‐19.45, ‐2.21]

Comparison 1. Rheum officinale versus no treatment

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Comparison 2. Rheum officinale versus captopril

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 CrCl Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

2 BUN Show forest plot	2	66	Mean Difference (IV, Random, 95% CI)	‐0.28 [‐2.21, 1.65]

3 Working capacity Show forest plot	1		Risk Ratio (M‐H, Random, 95% CI)	Totals not selected

3.1 Part‐time working capacity	1		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
3.2 Full‐time working capacity	1		Risk Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]

Comparison 2. Rheum officinale versus captopril

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Referencias

Referencias de los estudios incluidos en esta revisión

Gao 2004 {published data only}

Ge 1994 {published data only}

Ji 1993 {published data only}

Liu 2001a {published data only}

Shen 2008 {published data only}

Song 2000 {published data only}

Zhang 1990 {published data only}

Zhang 1993a {published data only}

Zhang 1993b {published data only}

Referencias de los estudios excluidos de esta revisión

Chang 2008 {published data only}

Chen 2002 {published data only}

Cui 2005 {published data only}

Hu 2006 {published data only}

Hu 2007 {published data only}

Huang 2007 {published data only}

Ju 2001 {published data only}

Li 1996a {published data only}

Li 1996b {published data only}

Li 2001 {published data only}

Li 2004 {published data only}

Lin 2004 {published data only}

Liu 2001b {published data only}

Liu 2002a {published data only}

Mao 1997 {published data only}

Ning 2009 {published data only}

Peng 1994 {published data only}

Qiu 1998 {published data only}

Shen 1994 {published data only}

Shen 2003 {published data only}

Sun 2000 {published data only}

Tong 2003 {published data only}

Wang 1997a {published data only}

Wang 1997b {published data only}

Yin 1998 {published data only}

Zhang 1993c {published data only}

Zhang 1995 {published data only}

Zou 1999 {published data only}

Referencias de los estudios en espera de evaluación

Gujrati 2001 {published data only}

Referencias adicionales

Abe 2000

ADR 2008

Chadban 2003

Chen 2005

Higgins 2003

Higgins 2011

Hillege 2001

Jafar 2001

Lefebvre 2011

Li 1991

Li 1996c

Li 1996d

Liu 1996

Liu 1999

Liu 2000

Liu 2002

Master List 2011

NKF 2002

Peng 2005

Renal Group 2011

Schieppati 2003

Shinya 1980

Strippoli 2006

Tang 1997

Vickers 1998

Wang 2001

Xu 2007

Yang 1993

Ye 2004

Yokozawa 1984

Zhang 1990

Zhang 1996

Zhang 1999

Zhang 2007

Referencias de otras versiones publicadas de esta revisión