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2017 ; 7
(1
): 1717
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Efficacy and safety of thiazolidinediones in diabetes patients with renal
impairment: a systematic review and meta-analysis
#MMPMID28496176
Wang W
; Zhou X
; Kwong JSW
; Li L
; Li Y
; Sun X
Sci Rep
2017[May]; 7
(1
): 1717
PMID28496176
show ga
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 from cohort
studies were similar to RCTs.
|Aged
[MESH]
|Body Weight
[MESH]
|Cardiovascular Diseases/etiology
[MESH]
|Case-Control Studies
[MESH]
|Diabetes Mellitus, Type 2/blood/complications/*drug therapy
[MESH]
|Edema/etiology
[MESH]
|Fasting/blood
[MESH]
|Female
[MESH]
|Glycated Hemoglobin/analysis
[MESH]
|Humans
[MESH]
|Kidney/*pathology
[MESH]
|Lipoproteins/blood
[MESH]
|Male
[MESH]
|Middle Aged
[MESH]
|Publication Bias
[MESH]
|Randomized Controlled Trials as Topic
[MESH]
|Risk Factors
[MESH]
|Thiazolidinediones/*adverse effects/*therapeutic use
[MESH]