Fermented Ophiocordyceps sinensis mycelium products for preventing contrast-associated acute kidney injury: a systematic review of randomized controlled trials

Fenglan Pu; Tianli Li; Chen Shen; Yingqiao Wang; Chunmei Tang; Xiaowen Zhang; Lijiao Yan; Qihe Xu; Jianping Liu

doi:10.1080/0886022X.2023.2300302

Fermented Ophiocordyceps sinensis mycelium products for preventing contrast-associated acute kidney injury: a systematic review of randomized controlled trials

Fenglan Pu, Tianli Li, Chen Shen, Yingqiao Wang, Chunmei Tang, Xiaowen Zhang, Lijiao Yan, Qihe Xu, Jianping Liu^*

^*Corresponding author for this work

Inflammation Biology

Research output: Contribution to journal › Review article › peer-review

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Abstract

Background: To evaluate the efficacy, effectiveness and safety of fermented Ophiocordyceps sinensis mycelium (FOSM) products for preventing contrast-associated acute kidney injury (CA-AKI). Methods: Randomized controlled trials were searched from four Chinese and four English electronic databases and three clinical trial registries up to July 2023. Methodological quality was assessed by using the Cochrane risk-of-bias tool 2.0. Risk difference (RD) or risk ratio (RR) and mean difference (MD) were calculated along with the 95% confidence intervals (CIs). Results: Fourteen trials testing three types of FOSM products (Bailing, Zhiling, and Jinshuibao capsules) involving 1271 participants injected contrast agents were included. For the risk of bias, all trials were rated as some concerns. Compared with routine preventive procedure (RPP) (saline hydration and alprostadil), FOSM products plus RPP showed beneficial effects in reducing the incidence of CA-AKI (14.62% and 5.35%, respectively; RD −0.06, 95% CI −0.09 to −0.03). Subgroup analysis showed that Bailing/Jinshuibao plus RPP demonstrated lower incidence of CA-AKI compared to RPP. However, there was no statistically significant difference between Zhiling with RPP and RPP in the incidence of CA-AKI. Additionally, only when FOSM products were taken before injection of the contrast, it was superior to RPP in reducing the incidence of CA-AKI. There was no statistical difference in adverse events between these two groups. Conclusions: Low certainty evidence suggests that preventive oral use of FOSM products as an adjuvant agent was safe and might decrease the incidence of CA-AKI. However, high-quality placebo-controlled trials are needed to confirm its benefit.

Original language	English
Article number	2300302
Journal	Renal Failure
Volume	46
Issue number	1
Early online date	8 Jan 2024
DOIs	https://doi.org/10.1080/0886022X.2023.2300302
Publication status	Published - 2024

Keywords

Chinese patent medicine
contrast-associated acute kidney injury
Ophiocordyceps sinensis
randomized clinical trials
systematic review

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Fermented Ophiocordyceps sinensis mycelium_Pu_publishedonline20September2024_Gold_VOR (CC BY-NC)Final published version, 4.66 MBLicence: CC BY-NC

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title = "Fermented Ophiocordyceps sinensis mycelium products for preventing contrast-associated acute kidney injury: a systematic review of randomized controlled trials",

abstract = "Background: To evaluate the efficacy, effectiveness and safety of fermented Ophiocordyceps sinensis mycelium (FOSM) products for preventing contrast-associated acute kidney injury (CA-AKI). Methods: Randomized controlled trials were searched from four Chinese and four English electronic databases and three clinical trial registries up to July 2023. Methodological quality was assessed by using the Cochrane risk-of-bias tool 2.0. Risk difference (RD) or risk ratio (RR) and mean difference (MD) were calculated along with the 95% confidence intervals (CIs). Results: Fourteen trials testing three types of FOSM products (Bailing, Zhiling, and Jinshuibao capsules) involving 1271 participants injected contrast agents were included. For the risk of bias, all trials were rated as some concerns. Compared with routine preventive procedure (RPP) (saline hydration and alprostadil), FOSM products plus RPP showed beneficial effects in reducing the incidence of CA-AKI (14.62% and 5.35%, respectively; RD −0.06, 95% CI −0.09 to −0.03). Subgroup analysis showed that Bailing/Jinshuibao plus RPP demonstrated lower incidence of CA-AKI compared to RPP. However, there was no statistically significant difference between Zhiling with RPP and RPP in the incidence of CA-AKI. Additionally, only when FOSM products were taken before injection of the contrast, it was superior to RPP in reducing the incidence of CA-AKI. There was no statistical difference in adverse events between these two groups. Conclusions: Low certainty evidence suggests that preventive oral use of FOSM products as an adjuvant agent was safe and might decrease the incidence of CA-AKI. However, high-quality placebo-controlled trials are needed to confirm its benefit.",

keywords = "Chinese patent medicine, contrast-associated acute kidney injury, Ophiocordyceps sinensis, randomized clinical trials, systematic review",

author = "Fenglan Pu and Tianli Li and Chen Shen and Yingqiao Wang and Chunmei Tang and Xiaowen Zhang and Lijiao Yan and Qihe Xu and Jianping Liu",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.",

year = "2024",

doi = "10.1080/0886022X.2023.2300302",

language = "English",

volume = "46",

journal = "Renal Failure",

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T1 - Fermented Ophiocordyceps sinensis mycelium products for preventing contrast-associated acute kidney injury

T2 - a systematic review of randomized controlled trials

AU - Pu, Fenglan

AU - Li, Tianli

AU - Shen, Chen

AU - Wang, Yingqiao

AU - Tang, Chunmei

AU - Zhang, Xiaowen

AU - Yan, Lijiao

AU - Xu, Qihe

AU - Liu, Jianping

PY - 2024

Y1 - 2024

N2 - Background: To evaluate the efficacy, effectiveness and safety of fermented Ophiocordyceps sinensis mycelium (FOSM) products for preventing contrast-associated acute kidney injury (CA-AKI). Methods: Randomized controlled trials were searched from four Chinese and four English electronic databases and three clinical trial registries up to July 2023. Methodological quality was assessed by using the Cochrane risk-of-bias tool 2.0. Risk difference (RD) or risk ratio (RR) and mean difference (MD) were calculated along with the 95% confidence intervals (CIs). Results: Fourteen trials testing three types of FOSM products (Bailing, Zhiling, and Jinshuibao capsules) involving 1271 participants injected contrast agents were included. For the risk of bias, all trials were rated as some concerns. Compared with routine preventive procedure (RPP) (saline hydration and alprostadil), FOSM products plus RPP showed beneficial effects in reducing the incidence of CA-AKI (14.62% and 5.35%, respectively; RD −0.06, 95% CI −0.09 to −0.03). Subgroup analysis showed that Bailing/Jinshuibao plus RPP demonstrated lower incidence of CA-AKI compared to RPP. However, there was no statistically significant difference between Zhiling with RPP and RPP in the incidence of CA-AKI. Additionally, only when FOSM products were taken before injection of the contrast, it was superior to RPP in reducing the incidence of CA-AKI. There was no statistical difference in adverse events between these two groups. Conclusions: Low certainty evidence suggests that preventive oral use of FOSM products as an adjuvant agent was safe and might decrease the incidence of CA-AKI. However, high-quality placebo-controlled trials are needed to confirm its benefit.

AB - Background: To evaluate the efficacy, effectiveness and safety of fermented Ophiocordyceps sinensis mycelium (FOSM) products for preventing contrast-associated acute kidney injury (CA-AKI). Methods: Randomized controlled trials were searched from four Chinese and four English electronic databases and three clinical trial registries up to July 2023. Methodological quality was assessed by using the Cochrane risk-of-bias tool 2.0. Risk difference (RD) or risk ratio (RR) and mean difference (MD) were calculated along with the 95% confidence intervals (CIs). Results: Fourteen trials testing three types of FOSM products (Bailing, Zhiling, and Jinshuibao capsules) involving 1271 participants injected contrast agents were included. For the risk of bias, all trials were rated as some concerns. Compared with routine preventive procedure (RPP) (saline hydration and alprostadil), FOSM products plus RPP showed beneficial effects in reducing the incidence of CA-AKI (14.62% and 5.35%, respectively; RD −0.06, 95% CI −0.09 to −0.03). Subgroup analysis showed that Bailing/Jinshuibao plus RPP demonstrated lower incidence of CA-AKI compared to RPP. However, there was no statistically significant difference between Zhiling with RPP and RPP in the incidence of CA-AKI. Additionally, only when FOSM products were taken before injection of the contrast, it was superior to RPP in reducing the incidence of CA-AKI. There was no statistical difference in adverse events between these two groups. Conclusions: Low certainty evidence suggests that preventive oral use of FOSM products as an adjuvant agent was safe and might decrease the incidence of CA-AKI. However, high-quality placebo-controlled trials are needed to confirm its benefit.

KW - Chinese patent medicine

KW - contrast-associated acute kidney injury

KW - Ophiocordyceps sinensis

KW - randomized clinical trials

KW - systematic review

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U2 - 10.1080/0886022X.2023.2300302

DO - 10.1080/0886022X.2023.2300302

M3 - Review article

C2 - 38189088

AN - SCOPUS:85181925880

SN - 0886-022X

VL - 46

JO - Renal Failure

JF - Renal Failure

IS - 1

M1 - 2300302

ER -

Fermented Ophiocordyceps sinensis mycelium products for preventing contrast-associated acute kidney injury: a systematic review of randomized controlled trials

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