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Submitted: 03 Jun 2021
Accepted: 23 Aug 2021
ePublished: 09 Sep 2021
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J Renal Inj Prev. 2021;10(4): e35.
doi: 10.34172/jrip.2021.35

Scopus ID: 85115654690
  Abstract View: 2235
  PDF Download: 1161

Review

Sodium-glucose co-transporter 2 inhibitors (SGLT2i); as a preventive factor of kidney failure in patients with type 2 diabetes; a meta-analysis of randomized controlled trials

Dorsa Jahangiri 1,2 ORCID logo, Udit Narayan Padhi 3 ORCID logo, Henu Kumar Verma 4 ORCID logo, Bhaskar VKS Lakkakula 3 ORCID logo, Rohollah Valizadeh 5,6 ORCID logo, Hamid Nasri 1* ORCID logo

1 Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Independent Researcher, 43185 Cardston Place Leesburg Virginia, 20176, USA
3 Department of Zoology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
4 Department of Immunopathology, Institute of lungs Biology and Disease, Comprehensive Pneumology Center, Helmholtz Zentrum, 85764 Neuherberg, Munich, Germany
5 Student Research Committee, Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
6 Minimally Invasive Surgery Research Center, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
*Corresponding Author: *Corresponding authors: : Prof. Hamid Nasri, hamidnasri@yahoo.com, , Email: hamidnasri@med.mui.ac.ir

Abstract

Introduction: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are a new class of anti-diabetic drugs. SGLT2 inhibitors lower blood glucose levels by decreasing glucose reabsorption in the proximal renal tubule, resulting in increased urinary glucose and sodium excretion.

Objective: This study was conducted to investigate the effects of SGLT2i on individual renal outcomes in diabetic patients.

Methods: This study was a systematic review and meta-analysis of clinical trials. A comprehensive search of Cochrane Central Register of Controlled Trials was conducted in the Cochrane Library and PubMed, to identify relevant articles focusing on SGLT2i and chronic kidney disease (CKD) in diabetic patients. The most recent article search was conducted on July 12, 2021.

Results: Seven randomized controlled trials (RCTs) were included in the meta-analysis. Two trials were comparing dapagliflozin, two comparing empagliflozin, one comparing ertugliflozin, one comparing canagliflozin, and one comparing sotagliflozin. Composite renal outcome and acute kidney injury (AKI) was found in seven and four studies, respectively. Data on end-stage kidney disease (ESKD) and albuminuria or initiation of renal replacement therapy were reported in the two studies. The pooled risk ratio (RR) 95% confidence interval (CI) for the composite renal outcome was 0.54 (0.50–0.59), with 92 % heterogeneity. The pooled RR for AKI was 0.77 (0.66–0.89), with no heterogeneity. A significant lower incidence of albuminuria (RR: 0.69; 95% CI: 0.59–0.81), initiation of renal replacement therapy (RR: 0.71; 95% CI: 0.58–0.87), was observed following the use of SGLT2 inhibitors.

Conclusion: Our findings confirm that the SGLT2 inhibitors can reduce the risk of albuminuria, AKI and renal replacement therapy in ESKD patients with T2D (type 2 diabetes). These meta-analyses provide substantial evidence supporting the beneficial effect of SGLT2 inhibitors on reducing CKD events in individuals with T2D.



Implication for health policy/practice/research/medical education:

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) lower blood glucose by reducing glucose reabsorption. SGLT2i was found to be beneficial in diabetic patients in randomized controlled trials. The current meta-analysis found that SGLT2 inhibitors may reduce the risk of kidney damage in T2D patients..

Please cite this paper as: Jahangiri D, Padhi UN, Kumar Verma HK, Lakkakula BVKS, Valizadeh R, Nasri H. Sodium-glucose co-transporter 2 inhibitors (SGLT2i); as a preventive factor of kidney failure in patients with type 2 diabetes; a meta-analysis of randomized controlled trials. J Renal Inj Prev. 2021; 10(4): e35. doi: 10.34172/jrip.2021.35.


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