Effect of multifactorial intensive treatment in patients with diabetic kidney disease: A meta‐analysis with trial sequential analysis
Authors' conclusion
The present study suggested that MT had a remarkable benefit on the risk of all-cause mortality and cardiovascular event disease in patients with DKD. Our results were promising, but had certain limitations, which warrants additional large-scale RCTs to validate our findings.
Study context
- Population
- Patients with diabetic kidney disease (DKD)5 randomized control trials (RCTs)
- Comparison
- Multifactorial intensive treatment vs control
- Outcome
- Efficacy and safety of MT
Methodological detailstrial sequential analysis, fixed-effect or random-effect model
- Trial sequential analysis
- Fixed-effect or random-effect model
Pooled result
As reported in the abstract
MTHazard ratio (95% CI)P value
All-cause mortality
0.75(0.60–0.93)
P = 0.008Cardiovascular event disease rate
0.55(0.44–0.68)
P < 0.001Further pooled results
Retinopathy progression
| HR (95% CI) | P value | ||
|---|---|---|---|
| MT | 0.79 (0.66–0.95) | P = 0.011 | |
| 0.512Hazard ratio (log scale) |
Progression of macroalbuminuria
| HR (95% CI) | P value | ||
|---|---|---|---|
| MT | 0.64 (0.43–0.95) | P = 0.027 | |
| 0.512Hazard ratio (log scale) |
Progression of microalbuminuria
| HR (95% CI) | P value | ||
|---|---|---|---|
| MT | 0.69 (0.56–0.86) | P = 0.001 | |
| 0.512Hazard ratio (log scale) |
Safety
All adverse events
| RR (95% CI) | P value | ||
|---|---|---|---|
| MT | 1.00 (0.97–1.03) | P = 0.830 | |
| 0.512Relative risk (log scale) |
All severe adverse events
| RR (95% CI) | P value | ||
|---|---|---|---|
| MTStatistical power confirmed by trial sequential analysis | 0.92 (0.74–1.15) | P = 0.478 | |
| 0.512Relative risk (log scale) |
Original publication
Effect of multifactorial intensive treatment in patients with diabetic kidney disease: A meta‐analysis with trial sequential analysis. Diabetes Obes Metab. Published 8 May 2023. doi:10.
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