Evidence map›Paper›PMID 37752340›Full record

SynthesisInternational urology and nephrology2024

Efficacy and safety of sodium-glucose cotransporter-2 inhibitors in patients with chronic kidney disease: a systematic review and meta-analysis.

Chu-Hsuan Shiau, Li-Yun Tsau, Chih-Chin Kao, Yu-Ching Peng, Chyi-Huey Bai, Jeng-Cheng Wu, Wen-Hsuan Hou

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International urology and nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Review
  6. Observational
  7. Review
  8. Observational
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Chu-Hsuan Shiau *Department of Education, Taipei Medical University Hospital, Taipei, Taiwan.ORCID http://orcid.org/0009-0003-2502-8309
Li-Yun Tsau *Graduate Institute of Clinical Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan.
Chih-Chin Kao *Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.ORCID http://orcid.org/0000-0003-3194-2204
Yu-Ching PengDepartment of Education, Taipei Medical University Hospital, Taipei, Taiwan.
Chyi-Huey BaiSchool of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.ORCID http://orcid.org/0000-0002-4658-1088
Jeng-Cheng Wu *Department of Education, Taipei Medical University Hospital, Taipei, Taiwan. wujengcheng@yahoo.com.tw.ORCID http://orcid.org/0000-0002-1045-5346
Wen-Hsuan Hou *Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. houwh@tmu.edu.tw.ORCID http://orcid.org/0000-0002-4376-6298

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOwing to the pharmacological mechanism, sodium-glucose cotransporter 2 inhibitors (SGLT2is) may be less effective in patients with reduced renal functions, but no systematic review or meta-analysis addressed chronic kidney disease (CKD) patients specifically. We aimed to assess the efficacy and safety of SGLT2is in CKD patients.

methodsWe conducted a systematic review and meta-analysis of randomized controlled trials. Mean difference (MD) were pooled for the decline of glomerular filtration rate (eGFR) and change in urine albumin-to-creatinine ratio (uACR). Hazard ratio (HR) and rate ratio (RR) were pooled for composite of renal outcomes and adverse effects.

resultsThirty articles were identified. Overall MD in rate of eGFR decline was 0.02 (P = 0.05), with a borderline significant difference favoring SGLT2is, while the change in uACR from baseline was - 141.34 mg/g and hazard ratio of composite renal outcomes was 0.64 significantly favoring SGLT2is. Subgroup analyses showed that the long-term renal function, participants with baseline macroalbuminuria, and stage 4 CKD patients had significantly slower eGFR decline rate in SGLT2is compared to the placebo group. Risks of genital mycotic infection and ketoacidosis were significantly higher among the SGLT2is group than placebo.

conclusionFor CKD patients, no matter diabetic or non-diabetic, our study showed potential renoprotective effects favoring SGLT2is in overall and long-term phase, and in patients with macroalbuminuria or stage 4 CKD. However, only slight increased risk of adverse effects among the SGLT2is group is observed. Therefore, we concluded that in CKD patients, prescribing SGLT2is was safe and had renal benefits.

Indexed as

Diabetes Mellitus, Type 2Diabetic NephropathiesRenal Insufficiency, ChronicSodium-Glucose Transporter 2 InhibitorsGlucoseHumansSodiumGlucoseSodiumSodium-Glucose Transporter 2 InhibitorsAdverse effectsChronic kidney disease (CKD)Composite renal outcomeMeta-analysisSodium–glucose cotransporter 2 inhibitors (SGLT2is)Systematic review

Identifiers

PMID37752340

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.