Effectiveness And Safety Of Activated Vitamin D In Patients With Diabetic Nephropathy: A Systematic Review Of Randomized Controlled Trials

Objective: Based on the domestic and foreign clinical trials related to activated vitamin D(VD) combined with angiotensin converting enzyme inhibitors(ACEI) or angiotensin Ⅱ receptor blocker(ARB) treatment, this meta-analysis aims to explore the effectiveness and safety of activated vitamin D treatment in Diabetic nephropathy(DN) patients.Methods: Electronic database searches was performed on the Cochrane library,PUBMED, EMBASE, CBM, CNKI, VIP, Wan fang. Data from the beginning of the database to January, 2015 were included, and were analysis by the principles and methods of Cochrane systematic reviews. Language restrictions were Chinese and English. Randomized controlled trials in ACEI or ARB combined activated vitamin D therapy for DN were selected and assessed for the methodological quality, and the extracted data were performed meta-analysis by statistical software Revman 5.12.Results: Eight studies, including 794 patients with DN, were included in this systemic review and meta-analysis. Compared with ACEI/ARB treatment group, 24-hour urinary protein level was significantly reduced in activated vitamin D plus ACEI/ARB treatment group[RR=-0.66,95%CI(-0.87,-0.46),P<0.0001 ]. But hemoglobin A1c(Hb A1c) [RR=-0.01,95%CI(-0.08,0.06), P=0.78]had no differences. did not increase the risk of adverse events[OR=1.28,95% CI(0.72,2.27),P=0.41].Conclusion: activated vitamin D could ameliorate proteinuria in patients with DN, whereas no increase in adverse effects. activated vitamin D treatment is safe and effective in DN patients. However, the validity of this finding requires supports of more large-size, prospective clinical trials.