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

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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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