Efficacy and safety of Bailing capsules combined with sodium glucose cotransporter inhibitors in diabetic kidney disease treatment

doi:10.4239/wjd.120131

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Meta-Analysis

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Diabetes. Jun 15, 2026; 17(6): 120131
Published online Jun 15, 2026. doi: 10.4239/wjd.120131

Efficacy and safety of Bailing capsules combined with sodium glucose cotransporter inhibitors in diabetic kidney disease treatment

Han Li, Fei-Hong Ren, Li-Ping Yang, Hui-Min Mao, Fang Ma, Yu-Yang Wang, Qi Jin, Peng-Yuan Liang, Yong-Li Zhan

Han Li, Fei-Hong Ren, Li-Ping Yang, Hui-Min Mao, Fang Ma, Yu-Yang Wang, Qi Jin, Yong-Li Zhan, Department of Nephrology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China

Peng-Yuan Liang, Department of Nephrology, Yangquan Coal Industry Group Co., Ltd. General Hospital, Yangquan 045000, Shanxi Province, China

Co-first authors: Han Li and Fei-Hong Ren.

Co-corresponding authors: Peng-Yuan Liang and Yong-Li Zhan.

Author contributions: Li H was responsible for conceptualization, data curation, formal analysis, investigation, methodology, software, validation, visualization, writing - original draft, and writing - review & editing; Ren FH was responsible for conceptualization, formal analysis, investigation, methodology, software, validation, visualization, writing - original draft, and writing - review & editing; Yang LP was responsible for conceptualization, data curation, formal analysis, methodology, and writing - review & editing; Mao HM was responsible for funding acquisition, investigation, supervision, and writing - review & editing; Ma F was responsible for investigation, methodology, and writing - review & editing; Wang YY was responsible for investigation and writing - review & editing; Jin Q was responsible for methodology and writing - review & editing; Liang PY was responsible for conceptualization, data curation, formal analysis, methodology, project administration, writing - original draft, and writing - review & editing; Zhan YL was responsible for conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, project administration, writing - original draft, and writing - review & editing; Li H and Ren FH have contributed equally to this work and share first authorship, Liang PY and Zhan YL contributed equally and share corresponding authorship, all authors have read and approved the final manuscript.

Supported by National Natural Science Foundation of China, No. 82305210 and No. 82374419; and Major Research Project Funding Project of Science and Technology Innovation Project of China Academy of Chinese Medical Sciences, No. CI2021A01210.

Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Corresponding author: Yong-Li Zhan, Professor, Department of Nephrology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 North Line Pavilion, Xicheng District, Beijing 100053, China. zhanyongli88@sina.com

Received: February 24, 2026
Revised: March 18, 2026
Accepted: April 23, 2026
Published online: June 15, 2026
Processing time: 116 Days and 2.1 Hours

Abstract

BACKGROUND

Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease. Integrative approaches combining traditional Chinese medicine and Western pharmacotherapy have shown potential benefits.

AIM

To evaluate the efficacy and safety of Bailing capsules (BCs) combined with SGLT2is in DKD treatment.

METHODS

Randomized controlled trials (RCTs) were retrieved from China National Knowledge Infrastructure, Wanfang, VIP, PubMed, Web of Science, EMBASE, and Cochrane Library up to September 14, 2025. Data extraction and quality assessment were performed independently by two reviewers using the Cochrane risk of bias tool. Meta-analysis was conducted with Stata 18.0, and trial sequential analysis (TSA) was applied to assess the robustness of evidence.

RESULTS

Fourteen RCTs involving 1919 patients were included. Compared with SGLT2is alone, BC plus SGLT2is significantly improved clinical efficacy [relative risk (RR) = 1.157, 95%CI: 1.102-1.216]; reduced fasting blood glucose [weighted mean difference (WMD) = -0.729, 95%CI: -0.976 to -0.482] and glycated hemoglobin (WMD = -0.680, 95%CI: -0.768 to -0.592) levels; altered renal function markers, including serum creatinine [SCr; standardized mean difference (SMD) = -1.033, 95%CI: -1.258 to -0.808], blood urea nitrogen (WMD = -1.158, 95%CI: -1.537 to -0.779), and β2-microglobulin (WMD = -1.237, 95%CI: -1.471 to -1.002) levels; and reduced 24-hour urinary protein levels (SMD = -1.329, 95%CI: -1.801 to -0.857). No significant increase in the incidence of adverse events was observed (RR = 0.939, P = 0.767). Subgroup analysis suggested that the optimal BC dosage was 1.0-3.0 g three times daily. TSA confirmed the reliability of the evidence for a reduction in SCr.

CONCLUSION

BC combined with SGLT2is appears to be effective and safe for improving glycemic control and renal function in DKD patients. Further high-quality, multicenter RCTs are warranted to validate these findings.

Keywords: Bailing capsules; SGLT2is; Diabetic kidney disease; Combination therapy; Meta-analysis

Core Tip: This meta-analysis of 14 randomized controlled trials including 1919 patients revealed that Bailing capsules combined with sodium-glucose cotransporter 2 inhibitors improved clinical efficacy, reduced blood glucose levels, and decreased serum creatinine levels and 24-hour urinary protein levels in patients with diabetic kidney disease (DKD). The safety profile of the combination therapy is comparable to that of control treatments and may provide a practical option for the integrated management of DKD.