Efficacy and safety of thiazolidinediones in diabetes patients with renal impairment: a systematic review and meta-analysis

Scientific Reports
Wen WangXin Sun

Abstract

We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of TZDs in treatment of diabetes mellitus patients with renal impairment. We searched PubMed, EMBASE and Cochrane Central Register of Controlled Trials. Randomized controlled trials (RCTs), cohort studies, and case-control studies that investigated the effects of TZDs in patients with diabetes and renal impairment were eligible. Outcomes included glycosylated hemoglobin, fasting plasma glucose, serum lipids, and patient-important outcomes (i.e. hypoglycemia, weight, edema, cardiovascular events and mortality). 19 RCTs and 3 cohort studies involving 21,803 patients with diabetes and renal impairment were included. Meta-analysis of RCTs showed that TZDs could significantly reduce HbA1c (MD -0.64, 95%CI -0.93 to -0.35), FPG (MD -26.27, 95%CI -44.90 to -7.64) and increase HDL levels (MD 3.70, 95%CI 1.10, 6.29). TZDs could increase weight (MD 3.23, 95% CI 2.29 to 4.16) and risk of edema (RR 2.96, 95% CI 1.22 to 7.20). Their effects on risk of hypoglycemia (RR 1.46, 95% CI 0.65 to 3.29), heart failure (RR 0.64, 95% CI 0.15 to 2.66), angina (RR 1.45, 95% CI 0.23 to 8.95) and all-cause mortality (RR 0.40, 95% CI 0.08 to 2.01) are uncertain. Results f...Continue Reading

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Citations

Oct 17, 2019·International Journal of Molecular Sciences·Hong Sheng ChengNguan Soon Tan
Aug 18, 2020·Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia·Manjuri SharmaGayatri Pegu
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Aug 20, 2018·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Dan QianBing Situ
Sep 22, 2020·International Journal of Clinical Practice·Bulent KayaGulfiliz Gonlusen
May 18, 2021·Diabetes & Metabolic Syndrome·Fakhriya Alalawi, Alaaeldin Bashier
Jul 13, 2021·Diabetes Research and Clinical Practice·Seung Eun LeeJoo Young Nam

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