The protective effects of curcumin against drug induced nephrotoxicity

A) using the grading of recommendations assessment, development and evaluation (GRADE) approach to grade the quality of evidence and strength of recommendations. Five downgrade factors must be considered as follows in this systematic review of animal studies:

(1) Risk of bias: the SYRCLE tool can be used for assessing the risk of bias of animal studies.

(2) Indirectness: Assess indirectness in systematic review of animal studies from the PICO.

(3) Inconsistency: similarity of point estimates, extent of overlap of confidence intervals (CIs), and statistical heterogeneity are also suitable to evaluate inconsistency of evidence from animal studies.

(4) Imprecision: optimal information size and 95% CIs are also suitable for systematic review of animal studies, like those of clinical trials.

(5) Publication bias: Consider publication bias comprehensively through the qualitative and quantitative methods.

B) in conclusion part of this systematic review these issues must be discussed. In addition to questionable quality of evidence, there are three major problems;

1) curcumin is a compound with poor bioavailability.

2) curcumin itself is chemically unstable.

Most papers do not describe how they have addressed this problem, which makes it difficult to understand which actual chemical entity has been administered.

3) Curcumin has recently been classified as both a PAINS (pan-assay interference compounds) and an IMPS (invalid metabolic panaceas) candidate.