Cochrane · systematic review · CD011798
Insulin and glucose‐lowering agents for treating people with diabetes and chronic kidney disease
Lo, C, Toyama, T, Wang, Y, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
Kidney and TransplantAMSTAR 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
36
No studies
4
Included studies
NR
No studies 4 · 10%Ungraded 0 · 0%Very low 15 · 37.5%Low 14 · 35%Moderate 7 · 17.5%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
SGLT2 inhibitors versus placebo for treating people with diabetes and chronic kidney disease (CKD)
Population: people with diabetes and CKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
HbA1c (%) HbA1c (mmol/mol) SGLT2 inhibitors vs placebo | no estimate extracted | 7 studies · 1092 participants | Moderate Downgraded: risk of bias |
FBG (mmol/L) SGLT2 inhibitors vs placebo | no estimate extracted | 5 studies · 855 participants | Moderate Downgraded: risk of bias |
Death (all causes) SGLT2 inhibitors vs placebo | no estimate extracted | 5 studies · 2933 participants | Very low Downgraded: risk of bias |
All cardiovascular death SGLT2 inhibitors vs placebo | no estimate extracted | 4 studies · 2788 participants | Low Downgraded: risk of bias |
Weight (kg) SGLT2 inhibitors vs placebo | no estimate extracted | 5 studies · 1029 participants | Low Downgraded: risk of bias |
eGFR (mL/min/1.73 m2) SGLT2 inhibitors vs placebo | no estimate extracted | 4 studies · 848 participants | Moderate Downgraded: risk of bias |
Hypoglycaemia SGLT2 inhibitors vs placebo | no estimate extracted | 7 studies · 3086 participants | Low Downgraded: risk of bias |
Discontinuation of medication due to adverse events SGLT2 inhibitors vs placebo | no estimate extracted | 4 studies · 917 participants | Very low Downgraded: risk of bias |
DPP‐4 inhibitors versus placebo for treating people with diabetes and chronic kidney disease (CKD)
Population: people with diabetes and CKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
HbA1c (%) HbA1c (mmol/mol) DPP‐4 inhibitors vs placebo | no estimate extracted | 7 studies · 867 participants | Low Downgraded: risk of bias |
FBG (mmol/L) DPP‐4 inhibitors vs placebo | no estimate extracted | 4 studies · 589 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Death (all causes) DPP‐4 inhibitors vs placebo | no estimate extracted | 6 studies · 4211 participants | Low Downgraded: risk of bias |
All cardiovascular death DPP‐4 inhibitors vs placebo | no estimate extracted | 2 studies · 5897 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Weight (kg) DPP‐4 inhibitors vs placebo | no estimate extracted | 2 studies · 210 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
eGFR (mL/min/1.73 m2) DPP‐4 inhibitors vs placebo | no estimate extracted | 1 study · 130 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Hypoglycaemia DPP‐4 inhibitors vs placebo | no estimate extracted | 11 studies · 1443 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Discontinuation of medication due to adverse events DPP‐4 inhibitors vs placebo | no estimate extracted | 7 studies · 1257 participants | Very low Downgraded: risk of bias |
GLP‐1 agonists versus placebo for treating people with diabetes and chronic kidney disease (CKD)
Population: people with diabetes and CKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
HbA1c (%) HbA1c (mmol/mol) GLP‐1 agonists vs placebo | no estimate extracted | 2 studies · 283 participants | Moderate Downgraded: risk of bias |
FBG (mmol/L) GLP‐1 agonists vs placebo | no estimate extracted | 1 study · 231 participants | Very low Downgraded: risk of bias |
Death (all causes) GLP‐1 agonists vs placebo | no estimate extracted | 2 studies · 301 participants | Very low Downgraded: risk of bias |
All cardiovascular death GLP‐1 agonists vs placebo | no estimate extracted | NR | No studies |
Weight (kg) GLP‐1 agonists vs placebo | no estimate extracted | 2 studies · 303 participants | Low Downgraded: risk of bias |
eGFR (mL/min/1.73 m2) GLP‐1 agonists vs placebo | no estimate extracted | 1 study · 279 participants | Low Downgraded: risk of bias |
Hypoglycaemia GLP‐1 agonists vs placebo | no estimate extracted | 2 studies · 303 participants | Low Downgraded: risk of bias |
Discontinuation of medication due to adverse events GLP‐1 agonists vs placebo | no estimate extracted | 2 studies · 303 participants | Low Downgraded: risk of bias |
Glitazone versus placebo for treating people with diabetes and chronic kidney disease (CKD)
Population: people with diabetes and CKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
HbA1c (%) HbA1c (mmol/mol) Glitazone vs placebo | no estimate extracted | 2 studies · 88 participants | Very low Downgraded: risk of bias |
FBG (mmol/L) Glitazone vs placebo | no estimate extracted | 5 studies · 233 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Death (all causes) Glitazone vs placebo | no estimate extracted | 1 study · 52 participants | Very low Downgraded: risk of bias |
All cardiovascular death Glitazone vs placebo | no estimate extracted | NR | No studies |
Weight (kg) Glitazone vs placebo | no estimate extracted | 5 studies · 222 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
eGFR (mL/min/1.73 m2) Glitazone vs placebo | no estimate extracted | NR | No studies |
Hypoglycaemia Glitazone vs placebo | no estimate extracted | 2 studies · 70 participants | Very low Downgraded: risk of bias |
Discontinuation of medication due to adverse events Glitazone vs placebo | no estimate extracted | 1 study · 63 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Sitagliptin versus glipizide for treating people with diabetes and chronic kidney disease (CKD)
Population: people with diabetes and CKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
HbA1c (%) HbA1c (mmol/mol) Sitagliptin vs glipizide | no estimate extracted | 2 studies · 398 participants | Low Downgraded: risk of bias |
FBG (mmol/L) Sitagliptin vs glipizide | no estimate extracted | 2 studies · 397 participants | Low Downgraded: risk of bias |
Death (all causes) Sitagliptin vs glipizide | no estimate extracted | 2 studies · 551 participants | Very low Downgraded: risk of bias |
All cardiovascular death Sitagliptin vs glipizide | no estimate extracted | NR | No studies |
Weight (kg) Sitagliptin vs glipizide | no estimate extracted | 2 studies · 552 participants | Low Downgraded: risk of bias |
eGFR (mL/min/1.73 m2) Sitagliptin vs glipizide | no estimate extracted | 2 studies · 552 participants | Low Downgraded: risk of bias |
Hypoglycaemia Sitagliptin vs glipizide | no estimate extracted | 2 studies · 551 participants | Moderate Downgraded: risk of bias |
Discontinuation of medication due to adverse events Sitagliptin vs glipizide | no estimate extracted | 2 studies · 551 participants | Very low Downgraded: risk of bias |