Evidence mapPaperPMID 41147324Full record

SynthesisDiabetes, obesity & metabolism2026

Comparison of the renal outcomes of novel antidiabetic agents in patients with type 2 diabetes with chronic kidney disease: A systematic review and network meta-analysis of randomized controlled trials.

Rong Lin, Chia-Li Hsu, Ming-Chieh Shih, Kuo-Liong Chien, Hon-Yen Wu

Abstract readSystematic ReviewComparative StudyNetwork Meta-Analysis
In one paragraph

Synthesis in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. 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

5 authors.

Rong LinDepartment of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Chia-Li HsuMinistry of Health and Welfare Shuang-Ho Hospital, New Taipei City, Taiwan.
Ming-Chieh ShihSchool of Medicine, National Tsing Hua University, Hsinchu, Taiwan.
Kuo-Liong ChienInstitute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.
Hon-Yen WuDepartment of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.ORCID 0000-0003-3121-3351

Funding

Far Eastern Memorial Hospital FEMH-2022-C-014Far Eastern Memorial Hospital FEMH-2023-C-010Far Eastern Memorial Hospital FEMH-2025-C-019National Health Research Institutes NHRI-EX112-11026PINational Health Research Institutes NHRI-EX114-11433PI
6 · The paper itself

Abstract

aimsTo investigate the renal outcomes of dipeptidyl peptidase 4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and sodium-glucose transport protein-2 (SGLT-2) inhibitors in patients with type 2 diabetes mellitus (T2DM) with chronic renal disease (CKD). MATERIALS AND

methodsPubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov were searched through July 2025 for randomized controlled trials with ≥24 weeks of follow-up in patients with T2DM and CKD. Outcomes included composite renal outcome, estimated glomerular filtration rate (eGFR), and urinary albumin-to-creatinine ratio (UACR). A network meta-analysis was conducted, and the certainty of evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation used to evaluate evidence certainty (GRADE).

resultsTwenty RCTs enrolling 80,670 participants were included. Compared with placebo, several agents significantly reduced composite renal outcomes, with dapagliflozin 10 mg showing the greatest efficacy (OR 0.55, 95% CI 0.42-0.72; high-certainty evidence), followed by canagliflozin, empagliflozin, efpeglenatide, sotagliflozin 400 mg, semaglutide, and dulaglutide 1.5 mg. Canagliflozin 100-300 mg significantly reduced UACR, whereas dapagliflozin had no effect. None of the novel antidiabetic agents significantly altered eGFR. Certainty of evidence ranged from high for placebo-controlled comparisons to low or very low for indirect estimates.

conclusionsIn patients with T2DM and CKD, SGLT2 inhibitors provide the most consistent renal protection, while GLP-1 receptor agonists offer additional but variable benefits. Dapagliflozin showed the greatest efficacy, and canagliflozin most strongly reduced albuminuria, highlighting meaningful heterogeneity across agents. DPP-4 inhibitors conferred no renal benefit. Overall, evidence from placebo-controlled trials was robust, whereas certainty was lower for indirect estimates, highlighting the need for drug-specific evaluation in clinical practice.

Indexed as

Diabetes Mellitus, Type 2Diabetic NephropathiesHypoglycemic AgentsRenal Insufficiency, ChronicDipeptidyl-Peptidase IV InhibitorsGlomerular Filtration RateGlucagon-Like Peptide-1 Receptor AgonistsHumansRandomized Controlled Trials as TopicSodium-Glucose Transporter 2 InhibitorsTreatment OutcomeDipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitorsantidiabetic drugdiabetic nephropathyDPP‐IV inhibitorGLP‐1 analoguenetwork meta‐analysisSGLT2 inhibitor

Identifiers

PMID41147324
PMCPMC12673457

What Socratic holds

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Registered trials

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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.