Effects of Renin–Angiotensin Inhibitors, Sodium–Glucose Cotransporter 2 Inhibitors, Mineralocorticoid Receptor Antagonists and Glucagon‐Like Peptide 1 Receptor Agonists on Kidney Outcomes in Patients With Type 1 Diabetes: A Systematic Review and Meta‐Analysis
Pooled result · UACRResult — go to the resultGeometric mean ratio 0.55 95% CI 0.32–0.94Authors' conclusion
In patients with T1DM, the pooled analysis showed a reduction in UACR overall, but that this appeared to be driven predominantly by the SGLT-2i studies, with limited and non-significant evidence in the RAS inhibitor subgroup.
Study context
- Population
- Adults (age ≥18) with T1D41 randomised controlled trials (RCTs)
- Comparison
- SGLT2i, RAS inhibitors, mineralocorticoid receptor antagonists (MRAs) and GLP-1 RAs vs placebo
- Outcome
- Change in UACR and eGFR
Methodological detailsSearched Medline, EMBASE, Cochrane CENTRAL, CINAHL, Global Health, LILACS and Scopus to 11 April 2025
- Searched Medline, EMBASE, Cochrane CENTRAL, CINAHL, Global Health, LILACS and Scopus to 11 April 2025
Pooled result
UACR
Geometric mean ratio
0.55
95% CI 0.32–0.94
SGLT-2i or RASivs Placebo
GMR 0.55 (95% CI 0.32–0.94)
As reported in the abstract
Further pooled results
| Outcome | Mean difference (mL/min/1.73 m²/year) (95% CI) | |
|---|---|---|
| Annual rate of eGFR changeTreatment (all drug classes)vs Placebo | 1.16 (−0.38 to 2.70) | |
| −2024Difference, mL/min/1.73 m²/year (linear scale) |
Annual rate of estimated glomerular filtration rate (eGFR) change
- No difference in annual rate of eGFR change across drug classes vs placebo
MRA trials
- No RCTs evaluating nsMRAs or MRAs met inclusion criteria
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| HypoglycaemiaTreatmentvs Placebo | 1.03 (1.01–1.05) | |
| DKATreatmentvs Placebo | 1.97 (1.33–2.93) | |
| 0.20.5125Relative risk (log scale) |
Original publication
Effects of Renin–Angiotensin Inhibitors, Sodium–Glucose Cotransporter 2 Inhibitors, Mineralocorticoid Receptor Antagonists and Glucagon‐Like Peptide 1 Receptor Agonists on Kidney Outcomes in Patients With Type 1 Diabetes: A Systematic Review and Meta‐Analysis. Diabetes Obes Metab. Published 13 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →