Yuzhu Qu, Jie Chen, Ling Yue, Xinyue Zhang, Kongmei Ou, Yiting Wang, Runjia He, Benxiang He
Diabetic nephropathy (DN) is a common complication of diabetes. Numerous preclinical studies have yielded inconsistent results in the treatment of DN with NAR. This review aimed to evaluate the effects of NAR on rodent models of DN, providing insights for future research and clinical translation. International biomedical and authoritative Chinese databases were searched to identify relevant records from their inception to 30 November 2025. Random-effects meta-analysis was performed to evaluate the standard mean difference (SMD) and 95% confidence interval (CI), with p ≤ 0.05 indicating statistical significance. Subgroup and sensitivity analyses were performed to assess the robustness of the results. Twelve studies were included in this meta-analysis. Pooled analysis mainly indicated that NAR reduced blood glucose (SMD = -3.10, 95% CI [-4.48, -1.73]), and protected the renal function (24-h urinary protein: SMD = -4.86, 95% CI [-5.85, -3.87]; serum creatinine: SMD = -4.51, 95% CI [-6.60, -2.41]). NAR also alleviated renal oxidative stress (malondialdehyde: SMD = -2.84, 95% CI [-4.62, -1.07]; glutathione: SMD = 1.73, 95% CI [0.62, 2.84]) and fibrosis (fibronectin: SMD = -6.60, 95% CI [-12.07, -1.12]; transforming growth factor-β1: SMD = -4.42, 95% CI [-8.05, -0.78]). These findings suggest that NAR may produce potential multi-target renal protective effects in DN by regulating blood glucose, inhibiting renal oxidative stress and fibrosis. This study was registered at PROSPERO as CRD420251274617.