Objective 　To assess the efficacy and safety of Sodium ferulate for diabetic kidney disease.
Methods 　Based on the principles and methods of Cochrane systematic reviews, we searched the Cochrane Central Register of Controlled Trials (Issue 4, 2008), MEDLINE (1996 to December 2008), EMbase (1980 to December 2008), CBMdisc (1990 to December 2008), CNKI (1994 to December 2008) and VIP (1989 to December 2008). And we also hand searched relevant journals and conference proceedings. We evaluated the risk of the bias of the included RCTs according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1. The Cochrane Collaboration’s software RevMan 5.0 was used for meta-analysis.
Results 　Thirty-nine RCTs were enrolled in the review, including 2 351 patients with type 2 diabetic kidney disease met the inclusion criteria. Most of these trials were small and of low quality with a high risk of bias. The results of meta-analysis showed that ① Sodium ferulate was better on attenuating UAER (WMD=– 42.92, 95%CI – 52.61 to – 33.23), 24 hours urinary protein (WMD=– 0.11, 95%CI – 0.16 to – 0.05), BUN (WMD=– 0.76, 95%CI – 1.04 to – 0.46) and Scr (WMD=– 8.38, 95%CI – 11.81 to – 4.94); Sodium ferulate was better on the regulation of FBG and 2 h-BG of clinical DKD (WMD= – 2.39, 95%CI – 3.23 to – 1.54), but not superior to routine treatment on the improvement of HbA1c (WMD= – 0.12, 95%CI – 0.27 to 0.02) and 2 h-BG of early DKD (WMD= – 0.22, 95%CI – 0.49 to 0.04); Sodium ferulate was better on the improvement of SBP and MAP, however, Sodium ferulate was not superior to routine treatment on the improvement of DBP; Sodium ferulate was better on the improvement of TC (WMD=– 0.70, 95%CI – 1.01 to – 0.39), HDL-c (WMD= 0.14, 95%CI 0.06 to 0.22) and TG of clinical DKD (WMD=– 0.96, 95%CI – 1.49 to – 0.43), but not superior to routine treatment on the improvement of TG of early DKD (WMD=– 0.12, 95%CI – 0.28 to 0.04); Sodium ferulate was better on the improvement of serum endothelin (WMD=– 18.72, 95%CI – 25.20 to – 12.23) and urinary endothelin (WMD=– 8.55, 95%CI – 10.92 to – 6.18). Only 8 studies mentioned sodium ferulate during treatment no adverse reactions or side effects, reportedly found in a study of mild and transient headache and a study of fatigue and dizziness. We have not seen the serious adverse events.
Conclusions 　Current evidence demonstrates that Sodium ferulate has certain effect and relatively safe in treating patients with diabetic kidney disease.Due to the heterogeneity and the high risk of bias in included studies,the evidence is insufficient to determine the effect of sodium ferulate.Further large-scale trials are required to define the role of sodium ferulate in the treatment of DKD.

Citation： WANG Feng,WANG Guogui,GE Weihong,LI Xiaoping,WU Yunhong,YUAN Qiyuan,LI Ting,WU Hongmei,SUN Hongjuan. Sodium Ferulate for Diabetic Kidney Disease: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(6): 652-669. doi: 10.7507/1672-2531.20090118 Copy