Journal Article

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

Zhang, Donglei, Yang, Xingsheng, Qin, Zheng, Meng, Jie, Zhou, Yilun, Gong, Yong, Yang, Yu, Liu, Xin, Bai, Xueyan

2024

Overview

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 I 2 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/1.73m 2 , 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.

• Publisher: BioMed Central,BioMed Central Ltd,BMC
• Subject: Albumin-to-creatinine ratio / Biomedical and Life Sciences / Care and treatment / Clinical Nutrition / Complications and side effects / Creatinine - blood / Creatinine - urine / Diabetes Mellitus, Type 2 - complications / Diabetes Mellitus, Type 2 - drug therapy / Diabetic nephropathies / Diabetic Nephropathies - drug therapy / Diagnosis / Dipeptidyl peptidase-4 inhibitors / Dipeptidyl-Peptidase IV Inhibitors - therapeutic use / Dosage and administration / Estimated glomerular filtration rate / Glomerular Filtration Rate - drug effects / Humans / Hypoglycemic agents / Kidney - drug effects / Kidney - physiopathology / Life Sciences / Lipidology / Medical Biochemistry / Randomized Controlled Trials as Topic / Risk factors / Type 2 diabetes / Type 2 diabetes mellitus