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