ferent populations. Methods: We conducted a meta-analysis of randomized controlled trials that tested GLP-1 RA treatment vs. placebo in individuals with type 2 diabetes (T2D) or with overweight/obesity status, with or without CKD, with kidney events reported as primary or secondary endpoints. The primary outcome was the occurrence of worsening kidney function, defined as either a doubling of serum creatinine or a ≥40% or ≥50% decline in estimated glomerular filtration rate (eGFR), according to each study report. Secondary outcomes included development of persistent macroalbuminuria and a composite of worsening kidney function or the development of persistent macroalbuminuria. Subgroup analyses were performed by eGFR and albuminuria categories. The results are presented as risk ratios (RR) with 95% confidence intervals (CI). Results: Eight trials were eligible, including a total of 68,572 patients, of which 34,042 (49.6%) received GLP-1 RA treatment. During follow-up, 1,028 participants receiving GLP-1 RA (3.0%) and 1,150 participants receiving placebo (3.5%) experienced worsening kidney function. Treatment with GLP-1 RA (vs placebo) resulted in a reduction in the risk of worsening kidney function (RR, 0.84; 95%CI, 0.77-0.91; p<0.001). Additionally, treatment with GLP-1 RA significantly reduced the risk of developing persistent macroalbuminuria and the risk of the composite outcome of worsening kidney function or development of persistent macroalbuminuria. The results were consistent in patients with and without CKD. Conclusions: In conclusion, our meta-analysis suggests that GLP-1 RA reduce kidney disease progression in T2D or overweight/obesity regardless of CKD status. Copyright © 2024 by the American Society of Nephrology...

中文翻译：

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胰高血糖素样肽 1 受体激动剂对肾脏结局的影响：随机安慰剂对照试验的荟萃分析


不同的人群。方法：我们对随机对照试验进行了荟萃分析，这些试验在 2 型糖尿病 （T2D） 或超重/肥胖状态的个体中测试了 GLP-1 RA 治疗与安慰剂，伴或不伴 CKD，肾脏事件报告为主要或次要终点。根据每项研究报告，主要结局是肾功能恶化的发生，定义为血清肌酐翻倍或估计肾小球滤过率 （eGFR） 下降 ≥40% 或 ≥50%。次要结局包括持续性大量白蛋白尿的发展和肾功能恶化或持续性大量白蛋白尿的复合发展。按 eGFR 和白蛋白尿类别进行亚组分析。结果以风险比 （RR） 和 95% 置信区间 （CI） 表示。结果： 8 项试验符合条件，共纳入 68,572 例患者，其中 34,042 例 （49.6%） 接受了 GLP-1 RA 治疗。在随访期间，1,028 名接受 GLP-1 RA 的参与者 （3.0%） 和 1,150 名接受安慰剂的参与者 （3.5%） 的肾功能恶化。GLP-1 RA 治疗（与安慰剂相比）导致肾功能恶化的风险降低 （RR， 0.84;95%CI， 0.77-0.91;p<0.001）。此外，GLP-1 RA 治疗显著降低了发生持续性大量白蛋白尿的风险以及肾功能恶化或持续性大量白蛋白尿的复合结局的风险。合并和不合并 CKD 的患者的结果一致。结论： 总之，我们的荟萃分析表明，无论 CKD 状态如何，GLP-1 RA 都可以减少 T2D 或超重/肥胖的肾脏疾病进展。美国肾脏病学会版权所有 © 2024...