Meta-analysis of the efficacy of glucagon-like peptide-1 receptor agonists in the treatment of diabetic nephropathy

Objective To systematically evaluate the efficacy of glucagon-like peptide-1 receptor agonists（Glp-1 ras） in the treatment of Diabetic Kidney Disease（DKD）. Methods Foreign language databases such as Pub Med, EMbase and Cochrane Library, and Chinese databases such as Wanfang data, China National Knowledge Infrastructure Project, Chinese biomedical literature service system and VIP periodical resource integration service platform were searched. The quality of the included studies was assessed according to the quality assessment criteria of the Cochrane handbook, and the data were analyzed by Rev Man 5.3 software. Results Thirteen randomized controlled trials involving 1136 DKD patients were finally included. The results showed that the glucagon-like peptide-1 receptor agonist treatment group significantly improved 24-h urinary protein[MD=−13.44, 95%CI（−17.09, −9.79）, I2=5%, P＜0.00001], urinary albumin/creatinine ratio[MD=−15.27, 95%CI（−17.12, −13.42）, I2=88%, P＜0.00001], blood-urea-nitrogen[MD=−1.21, 95%CI（−1.41, −1.00）, I2=27%, P＜0.00001], glycosylated hemoglobin[SMD=−1.12, 95%CI（−1.31, −0.94）, I2=38%, P＜0.00001], Serum creatinine[MD=−7.55, 95%CI（−9.92, −5.17）, I2=19%, P＜0.00001], total serum cholesterol[MD=−0.56, 95%CI（−0.70, −0.42）, I2=30%, P＜0.00001], and body mass index[MD=−3.61, 95%CI（−4.47, −2.76）, I2=0%, P＜0.00001, the differences were statistically significant. ConclusionGlucagon-like peptide-1 receptor agonists have good efficacy in the treatment of diabetic nephropathy, with a significant effect on changing renal outcomes and improving metabolic levels, although higher quality evidence is needed for validation.