Nephrotoxicity of Tripterygium wilfordii Hook. f Preparations: A Systematic Review and Meta-Analysis.

OBJECTIVE: To evaluate the incidence rate of nephrotoxicity in Tripterygium wilfordii Hook. f (TwHF) preparations approved by the China Food and Drug Administration and the potential risk factors.

METHODS: CENTRAL, PubMed, SinoMed, Chinese National Knowledge Infrastructure, VIP, China Important Conference Papers Database, China Dissertation Database, and online clinical trial registry websites were searched for articles that reported on nephrotoxicity of TwHF preparations until November 23, 2017. There was no limitation for study design.

RESULTS: A total of 36 articles involving 2,017 participants were included. Results showed that the incidence of nephrotoxicity associated with TwHF preparations was 5.81% (95% confidence interval: 4.43-7.57). Subgroup analysis showed that the disease type, combined medication, duration, and study design were not correlated with the incidence of nephrotoxicity.

CONCLUSION: The incidence rate of nephrotoxicity in TwHF preparations was 5.81%. The possible risk factors, such as disease type, the combination with other drugs, medication time, and study design, were not found to be correlated with the incidence of nephrotoxicity. However, due to the limited number of included articles, the limited sample size, and the poor methodology quality, the incidence rate of nephrotoxicity of TwHF preparations might be overestimated, and more prospective articles are needed to explore the potential influence factor.