Chen Jianyu, Xue Jisu, Chen Jiahui, Xie Tingfei, Sui Xiaolu, Zhang Yanzi, Zhang Aisha, Xu Yunpeng, Chen Jihong
Department of Nephrology, The Second People's Hospital of Shenzhen, Shenzhen, China.
Department of Nephrology, Affiliated Bao'an Hospital of Shenzhen, The Second School of Clinical Medicine, Southern Medical University, Shenzhen, China.
Front Endocrinol (Lausanne). 2024 Dec 20;15:1461754. doi: 10.3389/fendo.2024.1461754. eCollection 2024.
The study will evaluate the effectiveness and safety of finerenone in patients diagnosed with diabetic kidney disease (DKD).
Various databases including PubMed, Sinomed, Web of Science, Embase, Clinical Trials, and Cochrane Library were systematically reviewed for pertinent studies published from the beginning to February 2024.This meta-analysis utilized RevMan 5.3 and Stata 15.1.
The analysis of 4 randomized controlled trials involving 13,943 participants found that finerenone treatment significantly decreased the urine albumin-to-creatinine ratio compared to placebo. Additionally, the risk of COVID-19, cardiovascular events, and estimated glomerular filtration rate(eGFR) reduction of at least 40% were all significantly lower in the finerenone treatment group. However, the finerenone group did experience higher baseline increases in serum potassium levels. The meta-analysis revealed that there was no variation in the likelihood of general negative outcomes (RR 1.00, 95% CI 0.98, 1.01, I = 0%) and the occurrence of cancers (RR 0.99, 95% CI 0.83, 1.18,I = 0%) among the two categories.
Our study demonstrates that finerenone has the potential to lower the chances of end-stage kidney disease, renal failure and cardiovascular mortality in individuals with diabetic kidney disease. It is important to monitor for hyperkalemia risk. The administration of finelidone among individuals with diabetic kidney disease may potentially mitigate the susceptibility to contracting COVID-19.
https://www.crd.york.ac.uk/prospero/, identifier CRD42024536612.
本研究将评估非奈利酮在诊断为糖尿病肾病（DKD）患者中的有效性和安全性。
系统检索了包括PubMed、中国生物医学文献数据库、科学引文索引、Embase、临床试验和考克兰图书馆在内的多个数据库，以获取从开始到2024年2月发表的相关研究。本荟萃分析使用了RevMan 5.3和Stata 15.1。
对涉及13943名参与者的4项随机对照试验的分析发现，与安慰剂相比，非奈利酮治疗显著降低了尿白蛋白与肌酐比值。此外，非奈利酮治疗组的新型冠状病毒肺炎、心血管事件风险以及估计肾小球滤过率（eGFR）降低至少40%的情况均显著更低。然而，非奈利酮组确实经历了血清钾水平更高的基线升高。荟萃分析显示，两类人群中总体不良结局的可能性（风险比1.00，95%置信区间0.98，1.01，I² = 0%）和癌症发生率（风险比0.99，95%置信区间0.83，1.18，I² = 0%）没有差异。
我们的研究表明，非奈利酮有可能降低糖尿病肾病患者发生终末期肾病、肾衰竭和心血管死亡的几率。监测高钾血症风险很重要。在糖尿病肾病患者中使用非奈利酮可能会降低感染新型冠状病毒肺炎的易感性。
