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The efficacy and safety of SGLT2 inhibitors in patients with non-diabetic chronic kidney disease: a systematic review and meta-analysis

  • Nephrology - Original Paper
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Abstract

Purpose

In recent years, increasing evidence has shown that sodium-glucose cotransporter 2 inhibitors (SGLT2i) drugs have potential renoprotective effects in patients with diabetes mellitus (DM). However, the renal protective effect of SGLT2i in non-diabetic nephropathy patients has not been extensively demonstrated. In this systematic review and meta-analysis, we aimed to evaluate the renal protective effect and safety of SGLT2i in non-diabetic nephropathy patients.

Methods

we searched for relevant clinically randomised controlled trials and analyzed the effects of SGLT2i on estimated glomerular filtration rate (eGFR), urinary albumin/creatinine ratio (UACR), and systolic blood pressure (SBP) and the incidence of adverse events in patients with non-diabetic nephropathy.

Results

We collated and analysed clinical data from six groups of patients with nondiabetic nephropathy. It was found that the SGLT2i significantly delayed the decline in eGFR [MD = 1.35 ml/min/1.73 m2, 95% CI 0.84, 1.86), P < 0.0001]. Furthermore, the SGLT2i significantly reduced UACR [MD =  − 24.47% l, 95% CI (− 38.9, −10.04), P = 0.0009], and showed a greater decrease in SBP [MD =  − 4.13 mmHg, 95% CI (− 7.49, − 0.77), P = 0.02]. There was no significant difference in the incidence of adverse reactions between dapagliflozin/empagliflozin and the control group [OR = 1.14, 95% CI (0.88, 1.47), P = 0.33].

Conclusion

This study shows that SGLT2i help to delay the progression of non-diabetic kidney disease. Therefore, SGLT2i may contribute to the general treatment of nondiabetic nephropathy.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

Hubei Provincial Department of Education Natural Science Research Project Fund, B2017024, Ping Zhu, Yichang Medical and Health Research Project Fund, A20-2-002, Ping Zhu.

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Authors and Affiliations

  1. Institution of Nephrology, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, 443003, China

    Congyuan Ma, Xuanwei Li, Wenlai Li & Ping Zhu

  2. Department of endocrinology, The Renhe Hospital of Three Gorges University, Yichang, Hubei, 443003, China

    Yue Li & Fangfang Shui

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  1. Congyuan Ma
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  4. Yue Li
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Contributions

PZ and CM design. CM, XL, WL, YL, and FS conduct/data collection. CM and XL analysis. PZ and CM writing the manuscript. All authors contributed to the article and approved the submitted version.

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Correspondence to Ping Zhu.

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Ma, C., Li, X., Li, W. et al. The efficacy and safety of SGLT2 inhibitors in patients with non-diabetic chronic kidney disease: a systematic review and meta-analysis. Int Urol Nephrol 55, 3167–3174 (2023). https://doi.org/10.1007/s11255-023-03586-1

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