Protective effect of puerarin in diabetic nephropathy: A systematic review and meta-analysis of animal studies

Background: Puerarin is a crucial constituent separated from the Chinese herbaceous plant, Pueraria lobata (Willd.) Ohwi, which exhibits multiple biological activities. Previous studies have indicated that puerarin has a function to alleviate renal damage in animal models of diabetic nephropathy (DN). However, there is still a dearth of systematic preclinical studies. Purpose: This study was designed to assess the effectiveness of puerarin on DN through meta-analysis. Furthermore, it aimed to reveal the underlying mechanisms of puerarin's efficacy in treating DN. Methods: The animal studies were retrieved from 5 electronic databases. In total, 26 studies were included in our analysis. STATA 18.0 software was employed to evaluate crucial parameters, including fasting blood glucose (FBG), serum creatinine (SCr), blood urea nitrogen (BUN), proteinuria, oxidative stress, inflammatory responses, and lipid metabolism. Results: The results indicate that puerarin significantly improves FBG, SCr, BUN, proteinuria, and kidney index (KI). Additionally, puerarin enhances indicators of oxidative stress including superoxide dismutase (SOD), glutathione (GSH), and catalase (CAT), while reduces inflammatory indicators like interleukin 6 (IL-6), interleukin 1 beta (IL-1 beta), and tumor necrosis factor alpha (TNF-alpha). Moreover, puerarin lowers triglycerides (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL) levels. Conclusion: In conclusion, puerarin has the effect of improving renal function in DN animals possibly through antioxidative, anti-inflammatory, and the regulation of renal lipid accumulation, which offers preclinical support for its possible therapeutic use in the management of DN.