Abstract：
UNASSIGNED: The purpose of this systematic review and meta-analysis was to evaluate the common clinical adverse events associated with sodium/glucose cotransporter-2 inhibitor (SGLT2i) use compared to placebo in patients with chronic kidney disease (CKD) with or without type 2 diabetes.
UNASSIGNED: Twelve articles were chosen via a systematic search of the PubMed, Embase, and Cochrane Library databases. We screened for randomised placebo-controlled trials. The main clinical adverse events included diabetes ketoacidosis (DKA), amputation, and volume depletion. We performed heterogeneity testing and assessment of publication bias.
UNASSIGNED: In all, 65 600 patients were included in the analysis. Compared to placebo, SGLT2i may increase the risk of DKA and volume depletion in patients with CKD with or without type 2 diabetes. For DKA, compared with placebo, the combined effect of SGLT2i was OR 2.03 (95% CI: 1.28 to 3.23 I2: 2.3%, P: 0.420). For volume depletion, compared with placebo, the combined effect of SGLT2i was OR 1.24 (95% CI: 1.13 to 1.37 I2: 0.0%, P: 0.484). For the risk of amputation, despite low heterogeneity for amputation, the forest plot indicated no statistical significance, and thus it cannot be concluded that SGLT2i increases the risk of amputation. Compared with placebo, the combined effect of SGLT2i was OR 1.10 (95% CI: 0.94 to 1.29 I2: 0.0%, P: 0.642).
UNASSIGNED: The use of SGLT2i may increase the risk of DKA and volume depletion in patients with chronic renal insufficiency with or without type 2 diabetes.
UNASSIGNED: Twelve articles were chosen via a systematic search of the PubMed, Embase, and Cochrane Library databases. We screened for randomised placebo-controlled trials. The main clinical adverse events included diabetes ketoacidosis (DKA), amputation, and volume depletion. We performed heterogeneity testing and assessment of publication bias.
UNASSIGNED: In all, 65 600 patients were included in the analysis. Compared to placebo, SGLT2i may increase the risk of DKA and volume depletion in patients with CKD with or without type 2 diabetes. For DKA, compared with placebo, the combined effect of SGLT2i was OR 2.03 (95% CI: 1.28 to 3.23 I2: 2.3%, P: 0.420). For volume depletion, compared with placebo, the combined effect of SGLT2i was OR 1.24 (95% CI: 1.13 to 1.37 I2: 0.0%, P: 0.484). For the risk of amputation, despite low heterogeneity for amputation, the forest plot indicated no statistical significance, and thus it cannot be concluded that SGLT2i increases the risk of amputation. Compared with placebo, the combined effect of SGLT2i was OR 1.10 (95% CI: 0.94 to 1.29 I2: 0.0%, P: 0.642).
UNASSIGNED: The use of SGLT2i may increase the risk of DKA and volume depletion in patients with chronic renal insufficiency with or without type 2 diabetes.
摘要：
■本系统综述和荟萃分析的目的是评估与安慰剂相比，在患有或不患有2型糖尿病的慢性肾病（CKD）患者中，与使用钠/葡萄糖协同转运蛋白2抑制剂（SGLT2i）相关的常见临床不良事件。
■通过对PubMed的系统搜索选择了12篇文章，Embase,和Cochrane图书馆数据库。我们筛选了随机安慰剂对照试验。主要临床不良事件包括糖尿病酮症酸中毒(DKA),截肢,和体积消耗。我们进行了异质性测试和发表偏倚评估。
■总之，65600名患者被纳入分析。与安慰剂相比，SGLT2i可增加患有或不患有2型糖尿病的CKD患者的DKA和容量消耗的风险。对于DKA,与安慰剂相比，SGLT2i的综合效应为OR2.03（95％CI：1.28至3.23I2：2.3％，P:0.420)。对于体积耗尽，与安慰剂相比，SGLT2i的综合效应为OR1.24（95%CI：1.13至1.37I2：0.0%，P：0.484）。为了截肢的风险，尽管截肢的异质性较低，森林地块没有统计学意义，因此不能得出SGLT2i增加截肢风险的结论。与安慰剂相比，SGLT2i的联合效应为OR1.10（95%CI：0.94至1.29I2：0.0%，P:0.642)。
■在患有或不患有2型糖尿病的慢性肾功能不全患者中，使用SGLT2i可能会增加DKA和容量消耗的风险。
■通过对PubMed的系统搜索选择了12篇文章，Embase,和Cochrane图书馆数据库。我们筛选了随机安慰剂对照试验。主要临床不良事件包括糖尿病酮症酸中毒(DKA),截肢,和体积消耗。我们进行了异质性测试和发表偏倚评估。
■总之，65600名患者被纳入分析。与安慰剂相比，SGLT2i可增加患有或不患有2型糖尿病的CKD患者的DKA和容量消耗的风险。对于DKA,与安慰剂相比，SGLT2i的综合效应为OR2.03（95％CI：1.28至3.23I2：2.3％，P:0.420)。对于体积耗尽，与安慰剂相比，SGLT2i的综合效应为OR1.24（95%CI：1.13至1.37I2：0.0%，P：0.484）。为了截肢的风险，尽管截肢的异质性较低，森林地块没有统计学意义，因此不能得出SGLT2i增加截肢风险的结论。与安慰剂相比，SGLT2i的联合效应为OR1.10（95%CI：0.94至1.29I2：0.0%，P:0.642)。
■在患有或不患有2型糖尿病的慢性肾功能不全患者中，使用SGLT2i可能会增加DKA和容量消耗的风险。
