PMID- 37246403
OWN - NLM
STAT- MEDLINE
DCOM- 20230530
LR  - 20230601
IS  - 1525-6049 (Electronic)
IS  - 0886-022X (Print)
IS  - 0886-022X (Linking)
VI  - 45
IP  - 1
DP  - 2023 Dec
TI  - Comparative safety of sodium-glucose co-transporter 2 inhibitors in elderly 
      patients with type 2 diabetes mellitus and diabetic kidney disease: a systematic 
      review and meta-analysis.
PG  - 2217287
LID - 10.1080/0886022X.2023.2217287 [doi]
LID - 2217287
AB  - The safety of sodium-glucose co-transporter 2 (SGLT2) inhibitors in elderly 
      patients with diabetic kidney disease (DKD) is still controversial. This study 
      aimed to analyze the safety of SGLT2 inhibitors in elderly patients with type 2 
      diabetes mellitus (T2DM) and DKD. We systematically searched PubMed, Embase, Web 
      of Science, and the Cochrane Library from inception to March 2023. Randomized 
      controlled trials (RCTs) were included. Data including patient characteristics 
      and interesting outcomes were extracted, and the dichotomous data and continuous 
      variables were evaluated using risk ratio (RR) with 95% confidence intervals 
      (CIs) and mean difference (MD) with 95% CIs, respectively. A total of 14 RCTs 
      with 59874 participants were finally included. There were 38,252 males (63.9%) 
      and 21,622 females (36.1%). The patients' mean age was > 64.6 years. SGLT2 
      inhibitors could delay the further decline of estimated glomerular filtration 
      rate (eGFR) when eGFR >/= 60 ml/min/1.73m(2) (MD: 2.36; 95%CI [1.15-3.57]). SGLT2 
      inhibitors in elderly patients with eGFR < 60 ml/min/1.73m(2) (RR: 0.86; 95%CI 
      [0.67-1.11]) may have a relatively increased risk of acute kidney injury compared 
      to eGFR >/= 60 ml/min/1.73m(2). SGLT2 inhibitors increased the incidence of genital 
      mycotic infections (RR: 3.47; 95%CI [2.97-4.04]) and diabetic ketoacidosis (RR: 
      2.25; 95%CI [1.57-3.24]). Except for genital mycotic infections and diabetic 
      ketoacidosis, other adverse reactions were few, indicating that SGLT2 inhibitors 
      are relatively safe for elderly patients with T2DM and DKD. Safety and 
      renoprotection may be diminished when SGLT2 inhibitors are used in elderly 
      patients with eGFR < 60 ml/min/1.73m(2).
FAU - Liu, Yi
AU  - Liu Y
AUID- ORCID: 0000-0002-0223-5714
AD  - The First Clinical Medical College, Shandong University of Traditional Chinese 
      Medicine, Jinan, China.
FAU - An, Chuan
AU  - An C
AD  - The First Clinical Medical College, Shandong University of Traditional Chinese 
      Medicine, Jinan, China.
FAU - Liu, Peilong
AU  - Liu P
AD  - The First Clinical Medical College, Shandong University of Traditional Chinese 
      Medicine, Jinan, China.
FAU - Yang, Fan
AU  - Yang F
AD  - The First Clinical Medical College, Shandong University of Traditional Chinese 
      Medicine, Jinan, China.
FAU - Zhao, Quanlin
AU  - Zhao Q
AUID- ORCID: 0000-0001-5798-9428
AD  - Division of Comprehensive Internal Medicine, The Affiliated Hospital of Shandong 
      University of Traditional Chinese Medicine, Jinan, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - England
TA  - Ren Fail
JT  - Renal failure
JID - 8701128
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - 0 (Symporters)
RN  - IY9XDZ35W2 (Glucose)
RN  - 9NEZ333N27 (Sodium)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Male
MH  - Female
MH  - Humans
MH  - Aged
MH  - Middle Aged
MH  - *Sodium-Glucose Transporter 2 Inhibitors/adverse effects
MH  - *Diabetic Nephropathies/chemically induced
MH  - *Diabetic Ketoacidosis/chemically induced
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy
MH  - *Symporters
MH  - Glucose
MH  - Sodium
MH  - Hypoglycemic Agents/pharmacology
PMC - PMC10228313
OTO - NOTNLM
OT  - SGLT2 inhibitors
OT  - Type 2 diabetes mellitus
OT  - diabetic kidney disease
OT  - meta-analysis
COIS- No potential conflict of interest was reported by the author(s).
EDAT- 2023/05/29 06:42
MHDA- 2023/05/30 06:41
PMCR- 2023/05/29
CRDT- 2023/05/29 03:42
PHST- 2023/05/30 06:41 [medline]
PHST- 2023/05/29 06:42 [pubmed]
PHST- 2023/05/29 03:42 [entrez]
PHST- 2023/05/29 00:00 [pmc-release]
AID - 2217287 [pii]
AID - 10.1080/0886022X.2023.2217287 [doi]
PST - ppublish
SO  - Ren Fail. 2023 Dec;45(1):2217287. doi: 10.1080/0886022X.2023.2217287.