The Role of SGLT2 Inhibitors in Preventing the Progression of Chronic Kidney Disease in Patients with Type 2 DM: A Systematic Review.

Aidi Alifia Putri, Augris Shandrianti, Iche Andriyani Liberty
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Abstract

Background: Type 2 diabetes mellitus is the most common type of diabetes and is the leading cause of chronic kidney disease globally. Currently, the medications recommended for treatment are not fully effective for treating CKD. Recent findings from the DAPA-CKD and EMPA-KIDNEY clinical trials have revealed that SGLT-2 inhibitors offer significant benefits in improving kidney function and preventing the progression of kidney disease.

Objective: This review aims to evaluate the efficacy and safety of SGLT2 inhibitors in delaying CKD progression and reducing dialysis dependency in patients with type 2 diabetes.

Methods: This research is a systematic literature study using PRISMA 2020 Protocols. Article searches were carried out in PubMed, Cochrane Library, Sage Journals, and Europe PMC, covering the period from January 2019 to March 2024. The search strategy used the keywords "SGLT2 Inhibitor" AND "Prevention" AND "Chronic Kidney Disease" AND "Type 2 Diabetes". Articles that met the criteria were assessed for risk of bias using RoB2.

Results: From 7 articles with a total of 15,927 participants included in this systematic review, the overall risk of bias was low. Patients with type 2 diabetes and CKD who received SGLT2 inhibitors had a significantly lower risk of renal composite outcomes compared to placebo (e.g. HR 0.70, 95% CI 0.59-0.82). A modest initial decrease in eGFR was observed in the SGLT2i group compared to placebo, followed by stabilization over time.

Conclusion: SGLT2 inhibitors can be proposed as an effective treatment option for renal protection in patients with type 2 diabetes mellitus and chronic kidney disease, with moderate certainty of evidence from consistent RCT findings.

SGLT2抑制剂在预防2型糖尿病患者慢性肾病进展中的作用:一项系统综述
背景:2型糖尿病是最常见的糖尿病类型,也是全球慢性肾脏疾病的主要原因。目前,推荐的治疗药物对慢性肾病的治疗并不完全有效。最近来自DAPA-CKD和EMPA-KIDNEY临床试验的发现表明,SGLT-2抑制剂在改善肾功能和预防肾脏疾病进展方面具有显着益处。目的:本综述旨在评估SGLT2抑制剂延缓2型糖尿病患者CKD进展和降低透析依赖的有效性和安全性。方法:本研究采用PRISMA 2020协议进行系统文献研究。文章检索在PubMed、Cochrane Library、Sage Journals和Europe PMC中进行,检索时间为2019年1月至2024年3月。搜索策略使用关键词“SGLT2抑制剂”、“预防”、“慢性肾脏疾病”和“2型糖尿病”。使用RoB2对符合标准的文章进行偏倚风险评估。结果:本系统评价纳入7篇文章,共15927名受试者,总体偏倚风险较低。与安慰剂相比,接受SGLT2抑制剂治疗的2型糖尿病和CKD患者肾脏综合结局的风险显著降低(例如HR 0.70, 95% CI 0.59-0.82)。与安慰剂相比,SGLT2i组eGFR最初略有下降,随后随着时间的推移趋于稳定。结论:SGLT2抑制剂可作为2型糖尿病合并慢性肾病患者肾脏保护的有效治疗选择,且RCT结果一致,证据具有中等确定性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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