Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials
Large trials have shown that sodium glucose co-transporter-2 (SGLT2) inhibitors reduce the risk of adverse kidney and cardiovascular outcomes in patients with heart failure or chronic kidney disease, or with type 2 diabetes and high risk of atherosclerotic cardiovascular disease. None of the trials...
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| Published in: | The Lancet (British edition) Vol. 400; no. 10365; pp. 1788 - 1801 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
Elsevier Ltd
19.11.2022
Elsevier Limited |
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| ISSN: | 0140-6736, 1474-547X, 1474-547X |
| Online Access: | Get full text |
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| Abstract | Large trials have shown that sodium glucose co-transporter-2 (SGLT2) inhibitors reduce the risk of adverse kidney and cardiovascular outcomes in patients with heart failure or chronic kidney disease, or with type 2 diabetes and high risk of atherosclerotic cardiovascular disease. None of the trials recruiting patients with and without diabetes were designed to assess outcomes separately in patients without diabetes.
We did a systematic review and meta-analysis of SGLT2 inhibitor trials. We searched the MEDLINE and Embase databases for trials published from database inception to Sept 5, 2022. SGLT2 inhibitor trials that were double-blind, placebo-controlled, performed in adults (age ≥18 years), large (≥500 participants per group), and at least 6 months in duration were included. Summary-level data used for analysis were extracted from published reports or provided by trial investigators, and inverse-variance-weighted meta-analyses were conducted to estimate treatment effects. The main efficacy outcomes were kidney disease progression (standardised to a definition of a sustained ≥50% decrease in estimated glomerular filtration rate [eGFR] from randomisation, a sustained low eGFR, end-stage kidney disease, or death from kidney failure), acute kidney injury, and a composite of cardiovascular death or hospitalisation for heart failure. Other outcomes were death from cardiovascular and non-cardiovascular disease considered separately, and the main safety outcomes were ketoacidosis and lower limb amputation. This study is registered with PROSPERO, CRD42022351618.
We identified 13 trials involving 90 413 participants. After exclusion of four participants with uncertain diabetes status, we analysed 90 409 participants (74 804 [82·7%] participants with diabetes [>99% with type 2 diabetes] and 15 605 [17·3%] without diabetes; trial-level mean baseline eGFR range 37–85 mL/min per 1·73 m2). Compared with placebo, allocation to an SGLT2 inhibitor reduced the risk of kidney disease progression by 37% (relative risk [RR] 0·63, 95% CI 0·58–0·69) with similar RRs in patients with and without diabetes. In the four chronic kidney disease trials, RRs were similar irrespective of primary kidney diagnosis. SGLT2 inhibitors reduced the risk of acute kidney injury by 23% (0·77, 0·70–0·84) and the risk of cardiovascular death or hospitalisation for heart failure by 23% (0·77, 0·74–0·81), again with similar effects in those with and without diabetes. SGLT2 inhibitors also reduced the risk of cardiovascular death (0·86, 0·81–0·92) but did not significantly reduce the risk of non-cardiovascular death (0·94, 0·88–1·02). For these mortality outcomes, RRs were similar in patients with and without diabetes. For all outcomes, results were broadly similar irrespective of trial mean baseline eGFR. Based on estimates of absolute effects, the absolute benefits of SGLT2 inhibition outweighed any serious hazards of ketoacidosis or amputation.
In addition to the established cardiovascular benefits of SGLT2 inhibitors, the randomised data support their use for modifying risk of kidney disease progression and acute kidney injury, not only in patients with type 2 diabetes at high cardiovascular risk, but also in patients with chronic kidney disease or heart failure irrespective of diabetes status, primary kidney disease, or kidney function.
UK Medical Research Council and Kidney Research UK. |
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| AbstractList | Large trials have shown that sodium glucose co-transporter-2 (SGLT2) inhibitors reduce the risk of adverse kidney and cardiovascular outcomes in patients with heart failure or chronic kidney disease, or with type 2 diabetes and high risk of atherosclerotic cardiovascular disease. None of the trials recruiting patients with and without diabetes were designed to assess outcomes separately in patients without diabetes.
We did a systematic review and meta-analysis of SGLT2 inhibitor trials. We searched the MEDLINE and Embase databases for trials published from database inception to Sept 5, 2022. SGLT2 inhibitor trials that were double-blind, placebo-controlled, performed in adults (age ≥18 years), large (≥500 participants per group), and at least 6 months in duration were included. Summary-level data used for analysis were extracted from published reports or provided by trial investigators, and inverse-variance-weighted meta-analyses were conducted to estimate treatment effects. The main efficacy outcomes were kidney disease progression (standardised to a definition of a sustained ≥50% decrease in estimated glomerular filtration rate [eGFR] from randomisation, a sustained low eGFR, end-stage kidney disease, or death from kidney failure), acute kidney injury, and a composite of cardiovascular death or hospitalisation for heart failure. Other outcomes were death from cardiovascular and non-cardiovascular disease considered separately, and the main safety outcomes were ketoacidosis and lower limb amputation. This study is registered with PROSPERO, CRD42022351618.
We identified 13 trials involving 90 413 participants. After exclusion of four participants with uncertain diabetes status, we analysed 90 409 participants (74 804 [82·7%] participants with diabetes [>99% with type 2 diabetes] and 15 605 [17·3%] without diabetes; trial-level mean baseline eGFR range 37-85 mL/min per 1·73 m
). Compared with placebo, allocation to an SGLT2 inhibitor reduced the risk of kidney disease progression by 37% (relative risk [RR] 0·63, 95% CI 0·58-0·69) with similar RRs in patients with and without diabetes. In the four chronic kidney disease trials, RRs were similar irrespective of primary kidney diagnosis. SGLT2 inhibitors reduced the risk of acute kidney injury by 23% (0·77, 0·70-0·84) and the risk of cardiovascular death or hospitalisation for heart failure by 23% (0·77, 0·74-0·81), again with similar effects in those with and without diabetes. SGLT2 inhibitors also reduced the risk of cardiovascular death (0·86, 0·81-0·92) but did not significantly reduce the risk of non-cardiovascular death (0·94, 0·88-1·02). For these mortality outcomes, RRs were similar in patients with and without diabetes. For all outcomes, results were broadly similar irrespective of trial mean baseline eGFR. Based on estimates of absolute effects, the absolute benefits of SGLT2 inhibition outweighed any serious hazards of ketoacidosis or amputation.
In addition to the established cardiovascular benefits of SGLT2 inhibitors, the randomised data support their use for modifying risk of kidney disease progression and acute kidney injury, not only in patients with type 2 diabetes at high cardiovascular risk, but also in patients with chronic kidney disease or heart failure irrespective of diabetes status, primary kidney disease, or kidney function.
UK Medical Research Council and Kidney Research UK. Summary Background Large trials have shown that sodium glucose co-transporter-2 (SGLT2) inhibitors reduce the risk of adverse kidney and cardiovascular outcomes in patients with heart failure or chronic kidney disease, or with type 2 diabetes and high risk of atherosclerotic cardiovascular disease. None of the trials recruiting patients with and without diabetes were designed to assess outcomes separately in patients without diabetes. Methods We did a systematic review and meta-analysis of SGLT2 inhibitor trials. We searched the MEDLINE and Embase databases for trials published from database inception to Sept 5, 2022. SGLT2 inhibitor trials that were double-blind, placebo-controlled, performed in adults (age ≥18 years), large (≥500 participants per group), and at least 6 months in duration were included. Summary-level data used for analysis were extracted from published reports or provided by trial investigators, and inverse-variance-weighted meta-analyses were conducted to estimate treatment effects. The main efficacy outcomes were kidney disease progression (standardised to a definition of a sustained ≥50% decrease in estimated glomerular filtration rate [eGFR] from randomisation, a sustained low eGFR, end-stage kidney disease, or death from kidney failure), acute kidney injury, and a composite of cardiovascular death or hospitalisation for heart failure. Other outcomes were death from cardiovascular and non-cardiovascular disease considered separately, and the main safety outcomes were ketoacidosis and lower limb amputation. This study is registered with PROSPERO, CRD42022351618. Findings We identified 13 trials involving 90 413 participants. After exclusion of four participants with uncertain diabetes status, we analysed 90 409 participants (74 804 [82·7%] participants with diabetes [>99% with type 2 diabetes] and 15 605 [17·3%] without diabetes; trial-level mean baseline eGFR range 37–85 mL/min per 1·73 m2). Compared with placebo, allocation to an SGLT2 inhibitor reduced the risk of kidney disease progression by 37% (relative risk [RR] 0·63, 95% CI 0·58–0·69) with similar RRs in patients with and without diabetes. In the four chronic kidney disease trials, RRs were similar irrespective of primary kidney diagnosis. SGLT2 inhibitors reduced the risk of acute kidney injury by 23% (0·77, 0·70–0·84) and the risk of cardiovascular death or hospitalisation for heart failure by 23% (0·77, 0·74–0·81), again with similar effects in those with and without diabetes. SGLT2 inhibitors also reduced the risk of cardiovascular death (0·86, 0·81–0·92) but did not significantly reduce the risk of non-cardiovascular death (0·94, 0·88–1·02). For these mortality outcomes, RRs were similar in patients with and without diabetes. For all outcomes, results were broadly similar irrespective of trial mean baseline eGFR. Based on estimates of absolute effects, the absolute benefits of SGLT2 inhibition outweighed any serious hazards of ketoacidosis or amputation. Interpretation In addition to the established cardiovascular benefits of SGLT2 inhibitors, the randomised data support their use for modifying risk of kidney disease progression and acute kidney injury, not only in patients with type 2 diabetes at high cardiovascular risk, but also in patients with chronic kidney disease or heart failure irrespective of diabetes status, primary kidney disease, or kidney function. Funding UK Medical Research Council and Kidney Research UK. Large trials have shown that sodium glucose co-transporter-2 (SGLT2) inhibitors reduce the risk of adverse kidney and cardiovascular outcomes in patients with heart failure or chronic kidney disease, or with type 2 diabetes and high risk of atherosclerotic cardiovascular disease. None of the trials recruiting patients with and without diabetes were designed to assess outcomes separately in patients without diabetes. We did a systematic review and meta-analysis of SGLT2 inhibitor trials. We searched the MEDLINE and Embase databases for trials published from database inception to Sept 5, 2022. SGLT2 inhibitor trials that were double-blind, placebo-controlled, performed in adults (age ≥18 years), large (≥500 participants per group), and at least 6 months in duration were included. Summary-level data used for analysis were extracted from published reports or provided by trial investigators, and inverse-variance-weighted meta-analyses were conducted to estimate treatment effects. The main efficacy outcomes were kidney disease progression (standardised to a definition of a sustained ≥50% decrease in estimated glomerular filtration rate [eGFR] from randomisation, a sustained low eGFR, end-stage kidney disease, or death from kidney failure), acute kidney injury, and a composite of cardiovascular death or hospitalisation for heart failure. Other outcomes were death from cardiovascular and non-cardiovascular disease considered separately, and the main safety outcomes were ketoacidosis and lower limb amputation. This study is registered with PROSPERO, CRD42022351618. We identified 13 trials involving 90 413 participants. After exclusion of four participants with uncertain diabetes status, we analysed 90 409 participants (74 804 [82·7%] participants with diabetes [>99% with type 2 diabetes] and 15 605 [17·3%] without diabetes; trial-level mean baseline eGFR range 37–85 mL/min per 1·73 m2). Compared with placebo, allocation to an SGLT2 inhibitor reduced the risk of kidney disease progression by 37% (relative risk [RR] 0·63, 95% CI 0·58–0·69) with similar RRs in patients with and without diabetes. In the four chronic kidney disease trials, RRs were similar irrespective of primary kidney diagnosis. SGLT2 inhibitors reduced the risk of acute kidney injury by 23% (0·77, 0·70–0·84) and the risk of cardiovascular death or hospitalisation for heart failure by 23% (0·77, 0·74–0·81), again with similar effects in those with and without diabetes. SGLT2 inhibitors also reduced the risk of cardiovascular death (0·86, 0·81–0·92) but did not significantly reduce the risk of non-cardiovascular death (0·94, 0·88–1·02). For these mortality outcomes, RRs were similar in patients with and without diabetes. For all outcomes, results were broadly similar irrespective of trial mean baseline eGFR. Based on estimates of absolute effects, the absolute benefits of SGLT2 inhibition outweighed any serious hazards of ketoacidosis or amputation. In addition to the established cardiovascular benefits of SGLT2 inhibitors, the randomised data support their use for modifying risk of kidney disease progression and acute kidney injury, not only in patients with type 2 diabetes at high cardiovascular risk, but also in patients with chronic kidney disease or heart failure irrespective of diabetes status, primary kidney disease, or kidney function. UK Medical Research Council and Kidney Research UK. Large trials have shown that sodium glucose co-transporter-2 (SGLT2) inhibitors reduce the risk of adverse kidney and cardiovascular outcomes in patients with heart failure or chronic kidney disease, or with type 2 diabetes and high risk of atherosclerotic cardiovascular disease. None of the trials recruiting patients with and without diabetes were designed to assess outcomes separately in patients without diabetes.BACKGROUNDLarge trials have shown that sodium glucose co-transporter-2 (SGLT2) inhibitors reduce the risk of adverse kidney and cardiovascular outcomes in patients with heart failure or chronic kidney disease, or with type 2 diabetes and high risk of atherosclerotic cardiovascular disease. None of the trials recruiting patients with and without diabetes were designed to assess outcomes separately in patients without diabetes.We did a systematic review and meta-analysis of SGLT2 inhibitor trials. We searched the MEDLINE and Embase databases for trials published from database inception to Sept 5, 2022. SGLT2 inhibitor trials that were double-blind, placebo-controlled, performed in adults (age ≥18 years), large (≥500 participants per group), and at least 6 months in duration were included. Summary-level data used for analysis were extracted from published reports or provided by trial investigators, and inverse-variance-weighted meta-analyses were conducted to estimate treatment effects. The main efficacy outcomes were kidney disease progression (standardised to a definition of a sustained ≥50% decrease in estimated glomerular filtration rate [eGFR] from randomisation, a sustained low eGFR, end-stage kidney disease, or death from kidney failure), acute kidney injury, and a composite of cardiovascular death or hospitalisation for heart failure. Other outcomes were death from cardiovascular and non-cardiovascular disease considered separately, and the main safety outcomes were ketoacidosis and lower limb amputation. This study is registered with PROSPERO, CRD42022351618.METHODSWe did a systematic review and meta-analysis of SGLT2 inhibitor trials. We searched the MEDLINE and Embase databases for trials published from database inception to Sept 5, 2022. SGLT2 inhibitor trials that were double-blind, placebo-controlled, performed in adults (age ≥18 years), large (≥500 participants per group), and at least 6 months in duration were included. Summary-level data used for analysis were extracted from published reports or provided by trial investigators, and inverse-variance-weighted meta-analyses were conducted to estimate treatment effects. The main efficacy outcomes were kidney disease progression (standardised to a definition of a sustained ≥50% decrease in estimated glomerular filtration rate [eGFR] from randomisation, a sustained low eGFR, end-stage kidney disease, or death from kidney failure), acute kidney injury, and a composite of cardiovascular death or hospitalisation for heart failure. Other outcomes were death from cardiovascular and non-cardiovascular disease considered separately, and the main safety outcomes were ketoacidosis and lower limb amputation. This study is registered with PROSPERO, CRD42022351618.We identified 13 trials involving 90 413 participants. After exclusion of four participants with uncertain diabetes status, we analysed 90 409 participants (74 804 [82·7%] participants with diabetes [>99% with type 2 diabetes] and 15 605 [17·3%] without diabetes; trial-level mean baseline eGFR range 37-85 mL/min per 1·73 m2). Compared with placebo, allocation to an SGLT2 inhibitor reduced the risk of kidney disease progression by 37% (relative risk [RR] 0·63, 95% CI 0·58-0·69) with similar RRs in patients with and without diabetes. In the four chronic kidney disease trials, RRs were similar irrespective of primary kidney diagnosis. SGLT2 inhibitors reduced the risk of acute kidney injury by 23% (0·77, 0·70-0·84) and the risk of cardiovascular death or hospitalisation for heart failure by 23% (0·77, 0·74-0·81), again with similar effects in those with and without diabetes. SGLT2 inhibitors also reduced the risk of cardiovascular death (0·86, 0·81-0·92) but did not significantly reduce the risk of non-cardiovascular death (0·94, 0·88-1·02). For these mortality outcomes, RRs were similar in patients with and without diabetes. For all outcomes, results were broadly similar irrespective of trial mean baseline eGFR. Based on estimates of absolute effects, the absolute benefits of SGLT2 inhibition outweighed any serious hazards of ketoacidosis or amputation.FINDINGSWe identified 13 trials involving 90 413 participants. After exclusion of four participants with uncertain diabetes status, we analysed 90 409 participants (74 804 [82·7%] participants with diabetes [>99% with type 2 diabetes] and 15 605 [17·3%] without diabetes; trial-level mean baseline eGFR range 37-85 mL/min per 1·73 m2). Compared with placebo, allocation to an SGLT2 inhibitor reduced the risk of kidney disease progression by 37% (relative risk [RR] 0·63, 95% CI 0·58-0·69) with similar RRs in patients with and without diabetes. In the four chronic kidney disease trials, RRs were similar irrespective of primary kidney diagnosis. SGLT2 inhibitors reduced the risk of acute kidney injury by 23% (0·77, 0·70-0·84) and the risk of cardiovascular death or hospitalisation for heart failure by 23% (0·77, 0·74-0·81), again with similar effects in those with and without diabetes. SGLT2 inhibitors also reduced the risk of cardiovascular death (0·86, 0·81-0·92) but did not significantly reduce the risk of non-cardiovascular death (0·94, 0·88-1·02). For these mortality outcomes, RRs were similar in patients with and without diabetes. For all outcomes, results were broadly similar irrespective of trial mean baseline eGFR. Based on estimates of absolute effects, the absolute benefits of SGLT2 inhibition outweighed any serious hazards of ketoacidosis or amputation.In addition to the established cardiovascular benefits of SGLT2 inhibitors, the randomised data support their use for modifying risk of kidney disease progression and acute kidney injury, not only in patients with type 2 diabetes at high cardiovascular risk, but also in patients with chronic kidney disease or heart failure irrespective of diabetes status, primary kidney disease, or kidney function.INTERPRETATIONIn addition to the established cardiovascular benefits of SGLT2 inhibitors, the randomised data support their use for modifying risk of kidney disease progression and acute kidney injury, not only in patients with type 2 diabetes at high cardiovascular risk, but also in patients with chronic kidney disease or heart failure irrespective of diabetes status, primary kidney disease, or kidney function.UK Medical Research Council and Kidney Research UK.FUNDINGUK Medical Research Council and Kidney Research UK. |
| Author | Wanner, Christoph Heerspink, Hiddo J.L. Perkovic, Vlado Zannad, Faiez Brueckmann, Martina Jardine, Meg J. McGuire, Darren K. Solomon, Scott D. Roddick, Alistair J. Staplin, Natalie Sabatine, Marc S. Inzucchi, Silvio E. Vaduganathan, Muthiah Butler, Javed Preiss, David Bhatt, Deepak L. Judge, Parminder Liu, Chih-Chin Hauske, Sibylle J. Neal, Bruce Ng, Sarah Y.A. Baigent, Colin Green, Jennifer B. McMurray, John J.V. Cherney, David Z.I. McCausland, Finnian R. Herrington, William G. Anker, Stefan D. Landray, Martin J. Mayne, Kaitlin J. Neuen, Brendon L. Haynes, Richard Packer, Milton Mahaffey, Kenneth W. Wiviott, Stephen D. Zhu, Doreen Emberson, JonathanR Wheeler, David C. |
| AuthorAffiliation | 6 Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany 23 Stanford University School of Medicine, Stanford, CA 94305, USA 1 Renal Studies Group, Medical Research Council Population Health Research Unit at the University of Oxford, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK 15 British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK 4 George Institute for Global Health, Newtown, Australia; University of New South Wales, Sydney, New South Wales, Australia 8 Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany 17 TIMI Study Group 21 Department of Clinical Pharmacy and Pharmacology, University of Groningen, Groningen, the Netherlands 11 Division of Endocrinology, Department of Medicine and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA 3 Oxford Kidney Unit, Oxford University Hospitals NHS Foundation T |
| AuthorAffiliation_xml | – name: 22 Yale School of Medicine, New Haven, CT, USA – name: 24 Department of Renal Medicine, University College London, London, UK – name: 23 Stanford University School of Medicine, Stanford, CA 94305, USA – name: 1 Renal Studies Group, Medical Research Council Population Health Research Unit at the University of Oxford, Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK – name: 16 Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, TX, USA – name: 2 SGLT- inhibitor Meta-Analysis Cardio-Renal Trialists’ Consortium (SMART-C) – name: 13 Renal Division (F.R.M.), Brigham and Women’s Hospital, Boston, MA, USA – name: 18 Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA – name: 6 Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany – name: 10 Department of Medicine, University of Toronto, Toronto, Ontario, Canada – name: 5 Vth Department of Medicine, University Medical Center Mannheim, University of Heidelberg, Heidelberg, Germany – name: 17 TIMI Study Group – name: 20 Université de Lorraine, Inserm, Center d’Investigations Cliniques, - Plurithématique 14-33, and Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France – name: 3 Oxford Kidney Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK – name: 11 Division of Endocrinology, Department of Medicine and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA – name: 9 Baylor Scott and White Research Institute, TX and University of Mississippi, Jackson, MS, USA – name: 14 University of Texas Southwestern Medical Center, Parkland Health and Hospital System, Dallas, TX, USA – name: 15 British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK – name: 4 George Institute for Global Health, Newtown, Australia; University of New South Wales, Sydney, New South Wales, Australia – name: 8 Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany – name: 21 Department of Clinical Pharmacy and Pharmacology, University of Groningen, Groningen, the Netherlands – name: 19 Würzburg University Clinic, Würzburg, Germany – name: 7 Department of Cardiology (CVK), and Berlin Institute of Health Center for Regenerative Therapies, German Center for Cardiovascular Research Partner Site Berlin, Charité Universitätsmedizin, Berlin, Germany – name: 12 Merck & Co., Inc., Rahway, New Jersey, USA |
| Author_xml | – sequence: 1 givenname: Colin surname: Baigent fullname: Baigent, Colin – sequence: 2 givenname: JonathanR surname: Emberson fullname: Emberson, JonathanR – sequence: 3 givenname: Richard surname: Haynes fullname: Haynes, Richard – sequence: 4 givenname: William G. surname: Herrington fullname: Herrington, William G. – sequence: 5 givenname: Parminder surname: Judge fullname: Judge, Parminder – sequence: 6 givenname: Martin J. surname: Landray fullname: Landray, Martin J. – sequence: 7 givenname: Kaitlin J. surname: Mayne fullname: Mayne, Kaitlin J. – sequence: 8 givenname: Sarah Y.A. surname: Ng fullname: Ng, Sarah Y.A. – sequence: 9 givenname: David surname: Preiss fullname: Preiss, David – sequence: 10 givenname: Alistair J. surname: Roddick fullname: Roddick, Alistair J. – sequence: 11 givenname: Natalie surname: Staplin fullname: Staplin, Natalie – sequence: 12 givenname: Doreen surname: Zhu fullname: Zhu, Doreen – sequence: 13 givenname: Stefan D. surname: Anker fullname: Anker, Stefan D. – sequence: 14 givenname: Deepak L. surname: Bhatt fullname: Bhatt, Deepak L. – sequence: 15 givenname: Martina surname: Brueckmann fullname: Brueckmann, Martina – sequence: 16 givenname: Javed surname: Butler fullname: Butler, Javed – sequence: 17 givenname: David Z.I. surname: Cherney fullname: Cherney, David Z.I. – sequence: 18 givenname: Jennifer B. surname: Green fullname: Green, Jennifer B. – sequence: 19 givenname: Sibylle J. surname: Hauske fullname: Hauske, Sibylle J. – sequence: 21 givenname: Hiddo J.L. surname: Heerspink fullname: Heerspink, Hiddo J.L. – sequence: 23 givenname: Silvio E. surname: Inzucchi fullname: Inzucchi, Silvio E. – sequence: 24 givenname: Meg J. surname: Jardine fullname: Jardine, Meg J. – sequence: 25 givenname: Chih-Chin surname: Liu fullname: Liu, Chih-Chin – sequence: 26 givenname: Kenneth W. surname: Mahaffey fullname: Mahaffey, Kenneth W. – sequence: 27 givenname: Finnian R. surname: McCausland fullname: McCausland, Finnian R. – sequence: 28 givenname: Darren K. surname: McGuire fullname: McGuire, Darren K. – sequence: 29 givenname: John J.V. surname: McMurray fullname: McMurray, John J.V. – sequence: 30 givenname: Bruce surname: Neal fullname: Neal, Bruce – sequence: 31 givenname: Brendon L. surname: Neuen fullname: Neuen, Brendon L. – sequence: 32 givenname: Milton surname: Packer fullname: Packer, Milton – sequence: 33 givenname: Vlado surname: Perkovic fullname: Perkovic, Vlado – sequence: 34 givenname: Marc S. surname: Sabatine fullname: Sabatine, Marc S. – sequence: 35 givenname: Scott D. surname: Solomon fullname: Solomon, Scott D. – sequence: 36 givenname: Muthiah surname: Vaduganathan fullname: Vaduganathan, Muthiah – sequence: 37 givenname: Christoph surname: Wanner fullname: Wanner, Christoph – sequence: 38 givenname: David C. surname: Wheeler fullname: Wheeler, David C. – sequence: 39 givenname: Stephen D. surname: Wiviott fullname: Wiviott, Stephen D. – sequence: 40 givenname: Faiez surname: Zannad fullname: Zannad, Faiez |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36351458$$D View this record in MEDLINE/PubMed |
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| PublicationDate | 2022-11-19 |
| PublicationDateYYYYMMDD | 2022-11-19 |
| PublicationDate_xml | – month: 11 year: 2022 text: 2022-11-19 day: 19 |
| PublicationDecade | 2020 |
| PublicationPlace | England |
| PublicationPlace_xml | – name: England – name: London |
| PublicationTitle | The Lancet (British edition) |
| PublicationTitleAlternate | Lancet |
| PublicationYear | 2022 |
| Publisher | Elsevier Ltd Elsevier Limited |
| Publisher_xml | – name: Elsevier Ltd – name: Elsevier Limited |
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| Snippet | Large trials have shown that sodium glucose co-transporter-2 (SGLT2) inhibitors reduce the risk of adverse kidney and cardiovascular outcomes in patients with... Summary Background Large trials have shown that sodium glucose co-transporter-2 (SGLT2) inhibitors reduce the risk of adverse kidney and cardiovascular... |
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| SubjectTerms | Acute Kidney Injury Adolescent Adult Amputation Arteriosclerosis Atherosclerosis Bias Cardiovascular disease Cardiovascular diseases Clinical trials Collaboration Congestive heart failure Death Diabetes Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - drug therapy Diabetic ketoacidosis Disease Progression Ejection fraction End-stage renal disease Epidermal growth factor receptors Glomerular filtration rate Glucose Glucose transporter Health risks Heart diseases Heart Failure Hospitalization Humans Infections Inhibitors Injury prevention Ketoacidosis Ketosis Kidney Kidney diseases Kidneys Medical research Meta-analysis Mortality Patients Placebos Randomization Randomized Controlled Trials as Topic Renal failure Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - drug therapy Risk Sodium Sodium-Glucose Transporter 2 Sodium-Glucose Transporter 2 Inhibitors - adverse effects Transplants & implants Transportation safety Variance analysis |
| Title | Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials |
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