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

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...

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Autores principales:	Wen Wang, Xu Zhou, Joey S. W. Kwong, Ling Li, Youping Li, Xin Sun
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/32e03ca67afa4dd5bacc14d183bd9888
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spelling	oai:doaj.org-article:32e03ca67afa4dd5bacc14d183bd98882021-12-02T16:06:15ZEfficacy and safety of thiazolidinediones in diabetes patients with renal impairment: a systematic review and meta-analysis10.1038/s41598-017-01965-02045-2322https://doaj.org/article/32e03ca67afa4dd5bacc14d183bd98882017-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-01965-0https://doaj.org/toc/2045-2322Abstract 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.Wen WangXu ZhouJoey S. W. KwongLing LiYouping LiXin SunNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-11 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Wen Wang Xu Zhou Joey S. W. Kwong Ling Li Youping Li Xin Sun Efficacy and safety of thiazolidinediones in diabetes patients with renal impairment: a systematic review and meta-analysis
description	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 from cohort studies were similar to RCTs.
format	article
author	Wen Wang Xu Zhou Joey S. W. Kwong Ling Li Youping Li Xin Sun
author_facet	Wen Wang Xu Zhou Joey S. W. Kwong Ling Li Youping Li Xin Sun
author_sort	Wen Wang
title	Efficacy and safety of thiazolidinediones in diabetes patients with renal impairment: a systematic review and meta-analysis
title_short	Efficacy and safety of thiazolidinediones in diabetes patients with renal impairment: a systematic review and meta-analysis
title_full	Efficacy and safety of thiazolidinediones in diabetes patients with renal impairment: a systematic review and meta-analysis
title_fullStr	Efficacy and safety of thiazolidinediones in diabetes patients with renal impairment: a systematic review and meta-analysis
title_full_unstemmed	Efficacy and safety of thiazolidinediones in diabetes patients with renal impairment: a systematic review and meta-analysis
title_sort	efficacy and safety of thiazolidinediones in diabetes patients with renal impairment: a systematic review and meta-analysis
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/32e03ca67afa4dd5bacc14d183bd9888
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Efficacy and safety of thiazolidinediones in diabetes patients with renal impairment: a systematic review and meta-analysis

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