Glycaemic control and lipid-modifying drugs may slow CKD progression

  • Taylor KS & al.
  • BMJ Open
  • 20 Sep 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • This meta-analysis suggests that glycaemic control and lipid-modifying drugs may improve renal function in patients with chronic kidney disease (CKD) stages III and IV.
  • No significant differences in renal function were observed with antihypertensive drugs.

Why this matters

  • The finding is important given that CKD is a common progressive disease.
  • Glycaemic control, antihypertensive and lipid-modifying drugs are commonly used, but studies have concentrated on cardiovascular outcomes and not CKD outcomes.

Study design

  • 35 randomised controlled trials (RCTs; n=51,155) met eligibility criteria after a search across electronic databases.
  • Primary outcome: renal function (glomerular filtration rate [GFR], estimated GFR [eGFR], creatinine clearance [CrCl] and estimated CrCl).
  • Funding: The National Institute for Health Research.

Key results

  • The mean eGFR was 6% and 4% higher in those taking glycaemic control (ratio of means [ROM], 1.06; 95% CI, 1.02-1.10; low GRADE confidence) and lipid-modifying (ROM, 1.04; 95% CI, 1.00-1.08; I2=88%; very low-GRADE confidence) drugs, respectively.
  • Lipid-modifying drugs significantly reduced the risk for:
    • cardiovascular disease (relative risk [RR], 0.64; 95% CI, 0.52-0.80) and mortality (RR, 0.53; 95% CI, 0.30-0.92), and
    • all-cause mortality (RR, 0.74; 95% CI, 0.56-0.98).
  • Antihypertensive drugs did not show any benefit or harm on renal function.

Limitations

  • Heterogeneity across studies.
  • Results may have limited generalisability.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit