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Meta-Analysis
. 2024 May 25;23(1):157.
doi: 10.1186/s12944-024-02132-x.

Effect of DPP-4i inhibitors on renal function in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials

Yong Gong #  1 , Xueyan Bai #  2 , Donglei Zhang  3 , Xingsheng Yang  4 , Zheng Qin  4 , Yu Yang  4 , Yilun Zhou  5 , Jie Meng  6 , Xin Liu  7
Affiliations
Meta-Analysis

Effect of DPP-4i inhibitors on renal function in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials

Yong Gong et al. Lipids Health Dis. .

Abstract

Aims: About 20-40% patients with type 2 diabetes mellitus (T2DM) had an increased risk of developing diabetic nephropathy (DN). Dipeptidyl peptidase-4 inhibitors (DPP-4i) were recommended for treatment of T2DM, while the impact of DPP-4i on renal function remained unclear. This study aimed to explore the effect of DPP-4i on renal parameter of estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR) in T2DM.

Methods: A systematic search was performed across PubMed, Embase and Cochrane Library. A fixed or random-effects model was used for quantitative synthesis according to the heterogeneity, which was assessed with I2 index. Sensitivity analysis and publication bias were performed with standard methods, respectively.

Results: A total of 17 randomized controlled trials were identified. Administration of DPP-4i produced no significant effect on eGFR (WMD, -0.92 mL/min/1.73m2, 95% CI, -2.04 to 0.19) in diabetic condition. DPP-4i produced a favorable effect on attenuating ACR (WMD, -2.76 mg/g, 95% CI, -5.23 to -0.29) in patients with T2DM. The pooled estimate was stable based on the sensitivity test. No publication bias was observed according to Begg's and Egger's tests.

Conclusions: Treatment with DPP-4i preserved the renal parameter of eGFR in diabetic condition. Available evidences suggested that administration of DPP-4i produced a favorable effect on attenuating ACR in patients with T2DM. INTERNATIONAL PROSPECTIVE REGISTER FOR SYSTEMATIC REVIEW (PROSPERO) NUMBER: CRD.42020144642.

Keywords: Albumin-to-creatinine ratio; Dipeptidyl peptidase-4 inhibitors; Estimated glomerular filtration rate; Type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare no competing interests.

The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow chart for study selection
Fig. 2
Fig. 2
Risk of bias assessment in the studies identified for meta-analysis
Fig. 3
Fig. 3
Forest plot for the impact of DDP-4i versus placebo or active comparators on eGFR
Fig. 4
Fig. 4
Forest plot for the impact of DDP-4i versus placebo or active comparators on ACR
See this image and copyright information in PMC

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