The Efficacy And Safety Of Vitamin D For Patients With Type-2 Diabetic Nephropathy:a Systematic Review

Objective:Diabetes prevalence and morbidity are rising at home and abroad, diabetic nephropathy is an important one of complications, which influence public health and economic burden, but the current drugs for diabetic nephropathy curative effect is not clear, so we evaluate the efficacy and safety of vitamin D(VD) for patients with type-2 diabetic nephropathy.Methods:We searched the Pub Med、MEDLINE、CBM、CNKI and so on databases from January 1950 to May 2014 for relevant randomized controlled trials.Publications of the RCT on the treatment of type 2 diabetic nephropathy with VD were included and analyzed according to the criteria of Cocbrane handbook and Rev Man5.0 software.Including urine protein、serum creatinine and so on.The system analysis of measurement data, using the X2 test line heterogeneity test,when the P value is greater than 0.05 by using the fixed effects model,if not by using random effects model.Results:Fifteen RCT involving 1036 patients were included,the treatment 522,control group 512.According to the evaluation of the Cochrane handbook to evaluate 3 levels into literature, two of 15 articles class A and B respectively, others are grade C.Meta﹣analysis indicated that Compared with the control group,VD caused a reduction in 24-hour urinary protein quantity for 2-3 month(0.37% P=0.005)and 6 month(0.2% P<0.00001)respectively,and VD could effectively increase hs-CRP(0.79% P<0.00001),and increase blood calcium concentration in 6 month,but failed to influence serum creatinine.8 articles mentioned in VD treatment of adverse reactions, one piece mentioned hypercalcemia.Conclusion:VD May has positive effects on patients with type 2 diabetic nephropathy.However,The evidence is low quality.Thus we have not made a reliable conclusion about the effects of VD for type 2 diabetic nephropathy at the moment.Further larger,randomized,double-blind,placebo-Controlled and multicenter trials are warranted.