Efficacy and safety of jinlida granule in the treatment of diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials

Background Diabetic kidney disease (DKD), a major microvascular complication of diabetes, represents the leading cause of end-stage renal disease globally. Jinlida Granule (JLD), a multi-botanical Traditional Chinese Medicine preparation, has shown potential in type 2 diabetes management; however, a comprehensive systematic evaluation of its efficacy and safety specifically for DKD is lacking. Objective To systematically evaluate the efficacy and safety of JLD for DKD through a meta-analysis. Methods We conducted a systematic search of Chinese and English databases and clinical trial registries for randomized controlled trials (RCTs) on JLD for DKD from inception to 9 October 2025. Two researchers independently performed literature screening, data extraction, and quality assessment using the Cochrane Risk of Bias (RoB) 2 tool. Meta-analysis was conducted with a random-effects model using STATA 15.0 and Review Manager 5.4. Subgroup and sensitivity analyses were performed. Results Twelve RCTs involving 1,341 patients were included. JLD was associated with significant reductions in serum creatinine (MD −30.54 μmol/L, 95% CI −37.61 to −23.47; I 2 = 94%), blood urea nitrogen (MD −0.95 mmol/L, 95% CI −1.29 to −0.60; I 2 = 79%), urinary albumin excretion rate (MD −27.09 mg/24 h, 95% CI −29.16 to −25.02; I 2 = 94%), and HbA1c (MD −0.86%, 95% CI −1.23% to −0.49%; I 2 = 83%). Improvements were also observed in lipid profiles and inflammatory markers. Subgroup analyses suggested greater benefit in early-stage DKD and with specific combination regimens. Adverse events did not differ significantly between groups (RR 0.86, 95% CI 0.50–1.48). Substantial heterogeneity was noted. Conclusion Current evidence suggests that adjunctive JLD may provide multifaceted clinical benefits for DKD patients, with a comparable safety profile. However, these findings should be interpreted cautiously given the moderate to high risk of bias and considerable heterogeneity. Well-designed, large-scale RCTs are required. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251178318 , identifier [CRD420251178318].