Cochrane · systematic review · CD009966

Glucose‐lowering agents for treating pre‐existing and new‐onset diabetes in kidney transplant recipients

Lo, C, Toyama, T, Oshima, M, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library

Kidney and Transplant2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
40
current version
GRADE rated
27
No studies
13
Included studies
NR
No studies 13 · 32.5%Ungraded 0 · 0%Very low 16 · 40%Low 8 · 20%Moderate 3 · 7.5%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

More intensive versus less intensive insulin therapy for treating pre‐existing and new‐onset diabetes in kidney transplant recipients

Population: pre‐existing and new‐onset diabetes in kidney transplant recipients
8 questions
OutcomeEffectEvidenceStatus / GRADE
Transplant or graft survival
More intensive vs less intensive insulin therapy
RR 1.12 [0.32, 3.94]4 studies · 301 participantsVery low
Downgraded: risk of bias
Delayed graft function Time frame: 1 to 3 years
More intensive vs less intensive insulin therapy
RR 0.63 [0.42, 0.93]2 studies · 153 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
HbA1c Time frame: 13 months
More intensive vs less intensive insulin therapy
no estimate extracted1 study · 16 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
FBG (mmol/L) Time frame: 13 months
More intensive vs less intensive insulin therapy
no estimate extracted1 study · 24 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Kidney function markers: creatinine, eGFR Time frame: 1 year
More intensive vs less intensive insulin therapy
no estimate extracted1 study · 36 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Death (any cause) Time frame: 1 to 5 years
More intensive vs less intensive insulin therapy
RR 0.68 [0.29, 1.58]3 studies · 208 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Hypoglycaemia Time frame: 13 months to 5 years
More intensive vs less intensive insulin therapy
no estimate extracted4 studies · 301 participantsVery low
Downgraded: risk of bias
Discontinuation of medication due to adverse events Time frame: 1 year
More intensive vs less intensive insulin therapy
no estimate extracted1 study · 60 participantsVery low
Downgraded: risk of bias, imprecision, indirectness

DPP‐4 inhibitors versus placebo for treating pre‐existing and new‐onset diabetes in kidney transplant recipients

Population: pre‐existing and new‐onset diabetes in kidney transplant recipients
8 questions
OutcomeEffectEvidenceStatus / GRADE
Transplant or graft survival
DPP‐4 inhibitors vs placebo
no estimate extractedNRNo studies
Delayed graft function
DPP‐4 inhibitors vs placebo
no estimate extractedNRNo studies
HbA1c Time frame: 3 months
DPP‐4 inhibitors vs placebo
no estimate extracted1 study · 32 participantsLow
Downgraded: imprecision
FBG Time frame: 3 months
DPP‐4 inhibitors vs placebo
no estimate extracted1 study · 32 participantsLow
Downgraded: imprecision
Kidney function markers
DPP‐4 inhibitors vs placebo
no estimate extracted1 study · 32 participantsLow
Downgraded: imprecision
Death (any cause)
DPP‐4 inhibitors vs placebo
no estimate extractedNRNo studies
Hypoglycaemia Time frame: 8 to 16 weeks
DPP‐4 inhibitors vs placebo
no estimate extracted2 studies · 51 participantsVery low
Downgraded: imprecision
Discontinuation of medication due to adverse events Time frame: 8 to 16 weeks
DPP‐4 inhibitors vs placebo
no estimate extracted2 studies · 51 participantsVery low
Downgraded: imprecision

DPP‐4 inhibitors versus insulin glargine for treating pre‐existing and new onset diabetes in kidney transplant recipients

Population: pre‐existing and new onset diabetes in kidney transplant recipients
8 questions
OutcomeEffectEvidenceStatus / GRADE
Transplant or graft survival
DPP‐4 inhibitors vs insulin glargine
no estimate extractedNRNo studies
Delayed graft function
DPP‐4 inhibitors vs insulin glargine
no estimate extractedNRNo studies
HbA1c Time frame: 12 weeks
DPP‐4 inhibitors vs insulin glargine
no estimate extracted1 study · 45 participantsVery low
Downgraded: risk of bias
FBG Time frame: 12 weeks
DPP‐4 inhibitors vs insulin glargine
no estimate extracted1 study · 45 participantsVery low
Downgraded: risk of bias
Kidney function markers
DPP‐4 inhibitors vs insulin glargine
no estimate extractedNRNo studies
Death (any cause)
DPP‐4 inhibitors vs insulin glargine
no estimate extractedNRNo studies
Hypoglycaemia Time frame: 12 weeks
DPP‐4 inhibitors vs insulin glargine
no estimate extracted1 study · 45 participantsVery low
Downgraded: risk of bias
Discontinuation due to adverse events Time frame: 12 weeks
DPP‐4 inhibitors vs insulin glargine
no estimate extracted1 study · 45 participantsVery low
Downgraded: risk of bias

SGLT2 inhibitors versus placebo for treating pre‐existing and new‐onset diabetes in kidney transplant recipients

Population: pre‐existing and new‐onset diabetes in kidney transplant recipients
8 questions
OutcomeEffectEvidenceStatus / GRADE
Transplant or graft survival
SGLT2 inhibitors vs placebo
no estimate extracted1 study · 44 participantsModerate
Downgraded: imprecision
Delayed graft function
SGLT2 inhibitors vs placebo
no estimate extractedNRNo studies
HbA1c Time frame: 24 weeks
SGLT2 inhibitors vs placebo
no estimate extracted1 study · 44 participantsLow
Downgraded: imprecision
FBG (mmol/L) Time frame: 24 weeks
SGLT2 inhibitors vs placebo
no estimate extracted1 study · 44 participantsLow
Downgraded: imprecision
Kidney function markers
SGLT2 inhibitors vs placebo
no estimate extracted1 study · 44 participantsLow
Downgraded: imprecision
Death (any cause)
SGLT2 inhibitors vs placebo
no estimate extractedNRNo studies
Hypoglycaemia Time frame: 24 weeks
SGLT2 inhibitors vs placebo
no estimate extracted1 study · 44 participantsModerate
Downgraded: imprecision
Discontinuation of medication due to adverse events Time frame: 24 weeks
SGLT2 inhibitors vs placebo
no estimate extracted1 study · 49 participantsModerate
Downgraded: imprecision

Glitazones and insulin versus placebo and insulin for treating pre‐existing and new onset diabetes in kidney transplant recipients

Population: pre‐existing and new onset diabetes in kidney transplant recipients
8 questions
OutcomeEffectEvidenceStatus / GRADE
Transplant or graft survival
Glitazones and insulin vs placebo and insulin
no estimate extractedNRNo studies
Delayed graft function
Glitazones and insulin vs placebo and insulin
no estimate extractedNRNo studies
HbA1c Time frame: 16 weeks
Glitazones and insulin vs placebo and insulin
no estimate extracted1 study · 62 participantsVery low
FBG (mmol/L) Time frame: 16 weeks
Glitazones and insulin vs placebo and insulin
no estimate extracted2 studies · 120 participantsLow
Downgraded: risk of bias, imprecision, indirectness
Kidney function markers
Glitazones and insulin vs placebo and insulin
no estimate extracted1 study · 62 participantsVery low
Death (any cause)
Glitazones and insulin vs placebo and insulin
no estimate extractedNRNo studies
Hypoglycaemia
Glitazones and insulin vs placebo and insulin
no estimate extractedNRNo studies
Discontinuation of medication due to adverse events Time frame: 16 weeks
Glitazones and insulin vs placebo and insulin
no estimate extracted1 study · 71 participantsLow