Efficacy and safety of sodium-glucose cotransporter 2 inhibitors in patients with type 2 diabetes and moderate renal function impairment: A systematic review and meta-analysis.

AIMS: A systematic review and meta-analysis was conducted to evaluate the clinical efficacy and safety of sodium-glucose cotransporter 2 (SGLT2) inhibitors in patients with type 2 diabetes (T2D) and moderate renal function impairment.

METHODS: Embase, Medline, and Cochrane Central were searched, and randomized controlled trials comparing SGLT2 inhibitors to placebos and other drugs for T2D were collected.

RESULTS: Seven RCTs with a total of 3307 participants were included, and the overall bias was low. In the patients with T2D and moderate renal function impairment (30 ml/min/1.73 m2 ≤ estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 ) compared with the placebo, SGLT2 inhibitors improved HbA1c significantly (WMD, -0.23%; 95% CI: -0.38 to -0.08), presented a lower incidence of hypoglycemia (30.1% vs. 34.6%; RR, 0.85; 95% CI: 0.76 to 0.96), led to the reduction of eGFR (WMD, -1.74 ml/min/1.73 m2 ; 95% CI: -3.45 to -0.03), resulted in an obvious reduction in body weight (WMD, -1.45 kg; 95% CI: -2.01 to -0.89), and presented a similar risk of urinary tract infection and genital infection.

CONCLUSIONS: SGLT2 inhibitors are safe, but mildly reduce the HbA1c level. The clinical significance of SGLT2 inhibitors in the target population was limited.