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Shenzhuo Formula Improves Kidney Function Versus Irbesartan in 24-Week Diabetes Trial

Mechanistic data point to CX3CL1/MCP-1 inflammation as a plausible driver of the effect.

Overview

  • In a multicenter, randomized, double-blind study, 120 patients with diabetic kidney disease and macroalbuminuria were treated for 24 weeks with either the Shenzhuo Formula or irbesartan.
  • Both groups achieved similar reductions in 24-hour urinary protein, but the herbal therapy led to improved kidney function, with eGFR rising and serum creatinine falling compared with declines on irbesartan.
  • Olink proteomics showed significant decreases in inflammatory mediators CX3CL1 and MCP-1 after treatment with the herbal formula.
  • Single-nucleus RNA sequencing localized these inflammatory signals to endothelial, mesangial, and tubular cells, where treatment suppressed their expression.
  • Animal studies mirrored the clinical findings, and a Bayesian analysis supported a high probability of renal benefit, with investigators urging larger and longer trials to confirm efficacy and safety.