Meta-analysis Of Efficacy And Safety Of SGLT-2 Inhibitors In The Treatment Of Patients With Type 2 Diabetes With Chronic Kidney Disease

Objective:Systematic review of the effectiveness and safety of SGLT-2 inhibitors in the treatment of type 2 diabetes with chronic kidney disease based on conventional hypoglycemic therapy,and quantitative analysis.Methods:A computer search of the Cochrane Library,PubMed,CNKI,VIP,and Wanfang databases was used to collect randomized controlled trials of using Sodium-Glucose Cotransporter 2(SGLT-2)inhibitors to treat Type 2 Diabetes mellitus(T2DM)with Chronic Kidney Disease(CKD)(Randomized Controlled Trial(RCT),and the search period is from the time the database was built to February 2020.After 2 researchers screened the literature based on the inclusion and exclusion criteria,extracted the data,and evaluated the risk of bias in the included studies according to the Cochrane Handbook,the meta-analysis was performed using Revman 5.3 software.Results:A total of 14 literatures were included in the analysis,including 12609 patients,which 7448 patients in the test group and 5161 patients in the control group.Meta analysis results show that compared with the control group,the intervention of SGLT-2 inhibitors can reduce Glycated Hemoglobin A1c(HbA1c)(WMD=-0.30,95%CI:-0.36～-0.24,P<0.00001),Fasting Plasma Glucose(SMD=-0.51,95%CI:-0.76--0.26,P<0.0001),Body Weight(WMD=-1.57,95%CI:-1.72～-1.43,P<0.00001),eGFR(WMD=-1.82,95%CI:-2.93～-0.72,P=0.001),systolic blood pressure(WMD=-3.67,95%CI:-4.10～-3.23,P<0.00001),diastolic blood pressure(WMD=-2.47,95%CI:-3.10 to-1.84,P<0.00001)in patients with type 2 diabetes and chronic kidney disease.The overall risk of adverse events and death in the SGLT-2 inhibitor group was lower than that in the control group,but the risk of reproductive system infection and hypovolemia was higher than that in the control group.Conclusion:For patients with type 2 diabetes and chronic kidney disease,treatment with SGLT-2 inhibitors can further improve blood glucose and blood pressure control levels.It is needed to pay attention to the risk of reproductive system infection and insufficient blood volume.