Comparison of the renal outcomes of novel antidiabetic agents in patients with type 2 diabetes with chronic kidney disease: A systematic review and network meta‐analysis of randomized controlled trials
Pooled result · Composite renal outcomeResult — go to the resultOdds ratio 0.55 95% CI 0.42–0.72Authors' conclusion
In patients with T2DM and CKD, SGLT2 inhibitors provide the most consistent renal protection, while GLP-1 receptor agonists offer additional but variable benefits. Dapagliflozin showed the greatest efficacy, and canagliflozin most strongly reduced albuminuria, highlighting meaningful heterogeneity across agents. DPP-4 inhibitors conferred no renal benefit. Overall, evidence from placebo-controlled trials was robust, whereas certainty was lower for indirect estimates, highlighting the need for drug-specific evaluation in clinical practice.
Study context
- Population
- Patients with T2D and CKD in RCTs with ≥24 weeks of follow-up; searched through July 2025
- Participants
- 80,670 patients20 RCTs
- Comparison
- DPP-4i, GLP-1 RA and SGLT2i vs placebo
- Outcome
- Composite renal outcome
Methodological detailsGRADE certainty assessment
- GRADE certainty assessment
Pooled result
As reported in the abstract
Odds ratio
0.55
95% CI 0.42–0.72
Further pooled results
Urinary albumin-to-creatinine ratio (UACR)
- Canagliflozin 100-300 mg significantly reduced UACR; dapagliflozin had no effect
Estimated glomerular filtration rate (eGFR)
- None of the novel antidiabetic agents significantly altered eGFR
Certainty of evidence
- High for placebo-controlled comparisons; low or very low for indirect estimates
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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