| Objective: To systematically evaluate the protective effect of SGLT2 inhibitor on kidney in diabetic patients and provide evidence-based medical basis for the treatment of diabetic nephropathy.Methods : Inclusion,exclusion criteria and search strategies were developed to comprehensively search Chinese and English databases.Clinical randomized controlled trials of SGLT2 inhibitors in the treatment of diabetes were obtained.Two authors independently extracted data according to the design scheme and evaluated the quality of the included studies.Data analysis was performed using Revman 5.3 software to compare the effects of the intervention group(SGLT2 inhibitor group)and the control group on e GFR and UACR in diabetic patients.Results: 1.A total of 22 clinical randomized controlled trials that met the inclusion criteria were published in English.A total of 22,631 patients,including 13855 in the intervention group and 8776 in the control group.2.The effect of e GFR on diabetic patients: Compared with the control group,the low-dose intervention group had no difference in the effect of e GFR,and it was not statistically significant [P=0.25,SMD=0.33 95% CI(-0.23,0.89)] The high-dose intervention group initially reduced e GFR slightly,but gradually increased with the course of treatment,the difference was statistically significant [P=0.0004 SMD=-0.45 95% CI(-0.70,-0.20)].3.The effect of UACR on diabetic patients: Compared with the control group,the intervention group can reduce UACR,the difference is statistically significant[P=0.008MD=-42.69,95%CI(-74.35,-11.04)] 4.Safety evaluation: Compared with the control group,the incidence of reproductive system infection increased in the intervention group,the difference was statistically significant [P<0.00001OR=4.54 95% CI(3.78,5.46)],adverse events,urinary tract infection events,hypoglycemia events,renal injury events There was no significant difference in the incidence of fracture events.Conclusion: SGLT2 inhibitors can play a potential role in direct renal protection during continuous treatment.It is safer to use,but because of the limitations of this study,the results need to be interpreted carefully.More large randomized double-blind controlled clinical trials are needed.Real-world research to provide evidence for evidence-based medicine and guide clinical practice.. |
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