Kidney medicine · 2026
Sodium-Glucose Cotransporter-2 Inhibitors and Acute Kidney Injury Risk: A Systematic Review and Meta-Analysis of Randomized Trials.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Chiang Yu-Cheng, Dai Dao-Fu, Chiu Yi-Wen, Lin Hugo Y-H
Аннотация
RATIONALE & OBJECTIVE: Sodium-glucose cotransporter-2 inhibitors (SGLT2is) provide cardiovascular and renal benefits in individuals with or without type 2 diabetes. This systematic review and meta-analysis investigated the risks of acute kidney injury and other adverse events (AEs) associated with SGLT2is across diverse populations.
STUDY DESIGN: Systematic review and meta-analysis of randomized controlled trials (RCTs).
SETTING & STUDY POPULATIONS: Thirteen RCTs comprising 84,581 participants were included. The studies encompassed diverse populations, varying in diabetes status, presence of chronic kidney disease, and SGLT2i dosages.
SELECTION CRITERIA FOR STUDIES: We included RCTs published through December 31, 2023, that evaluated the safety and efficacy of SGLT2is and reported renal and nonrenal adverse outcomes.
DATA EXTRACTION: Two reviewers independently extracted data and resolved discrepancies by consensus, focusing on renal and nonrenal AEs and subgroup analyses.
ANALYTICAL APPROACH: Random-effects meta-analysis was performed to estimate pooled relative risks or odds ratios with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic.
RESULTS: SGLT2is were associated with a 20% reduction in the risk of acute kidney injury (relative risk, 0.80; 95% CI, 0.74-0.87), with low between-study heterogeneity, supporting a consistent renoprotective effect. Among patients with chronic kidney disease, the risk of renal composite outcomes was also significantly reduced (odds ratio, 0.70; 95% CI, 0.62-0.79). However, treatment was associated with increased risks of genital infections (P < 0.001), urinary tract infections (P = 0.03), diabetic ketoacidosis (P < 0.001), and hypovolemia (P = 0.008). No significant differences were observed for hypoglycemia (P = 0.08) or lower limb amputation (P = 0.07).
LIMITATIONS: Variability in study design, definitions of AEs, and patient baseline characteristics may influence the findings.
CONCLUSIONS: SGLT2is conferred substantial renoprotective benefits but increases the risk of certain nonrenal AEs. Tailored treatment and close monitoring are crucial to ensure safety and efficacy, especially in high-risk patients.
STUDY DESIGN: Systematic review and meta-analysis of randomized controlled trials (RCTs).
SETTING & STUDY POPULATIONS: Thirteen RCTs comprising 84,581 participants were included. The studies encompassed diverse populations, varying in diabetes status, presence of chronic kidney disease, and SGLT2i dosages.
SELECTION CRITERIA FOR STUDIES: We included RCTs published through December 31, 2023, that evaluated the safety and efficacy of SGLT2is and reported renal and nonrenal adverse outcomes.
DATA EXTRACTION: Two reviewers independently extracted data and resolved discrepancies by consensus, focusing on renal and nonrenal AEs and subgroup analyses.
ANALYTICAL APPROACH: Random-effects meta-analysis was performed to estimate pooled relative risks or odds ratios with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic.
RESULTS: SGLT2is were associated with a 20% reduction in the risk of acute kidney injury (relative risk, 0.80; 95% CI, 0.74-0.87), with low between-study heterogeneity, supporting a consistent renoprotective effect. Among patients with chronic kidney disease, the risk of renal composite outcomes was also significantly reduced (odds ratio, 0.70; 95% CI, 0.62-0.79). However, treatment was associated with increased risks of genital infections (P < 0.001), urinary tract infections (P = 0.03), diabetic ketoacidosis (P < 0.001), and hypovolemia (P = 0.008). No significant differences were observed for hypoglycemia (P = 0.08) or lower limb amputation (P = 0.07).
LIMITATIONS: Variability in study design, definitions of AEs, and patient baseline characteristics may influence the findings.
CONCLUSIONS: SGLT2is conferred substantial renoprotective benefits but increases the risk of certain nonrenal AEs. Tailored treatment and close monitoring are crucial to ensure safety and efficacy, especially in high-risk patients.