Treatment for CKD: a systematic literature review and population comparison

Scott, David Alexander (2020) Treatment for CKD: a systematic literature review and population comparison. Kidney Week.

Record type: Conference or Workshop Item (Other)

Abstract

Background: DAPA-CKD is the first renal outcomes trial assessing the efficacy and safety of a sodium–glucose cotransporter-2 inhibitor, dapagliflozin, vs placebo, added to standard of care in patients with chronic kidney disease (CKD) with/without type 2 diabetes (T2D). Several other agents have been or are currently under investigation for their effect on renal and cardiovascular outcomes in CKD; however, comparisons of efficacy are challenging, due to differences in study design, duration, patients and endpoint definitions. We conducted a systematic literature review of randomized controlled trials (RCTs) in CKD, with the aim of assessing inter-study comparability.

Methods: searches of MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and grey literature sources were conducted to identify phase 3–4 RCTs of adults (≥18 years) with albuminuric CKD with/without T2D, published in English between 1990 and March 25, 2020. Studies of ≥12 weeks duration that reported clinical outcomes, adverse events, quality of life or patient-reported outcomes for pharmacologic CKD treatments were eligible for inclusion.

Results: preliminarily, 13,451 unique citations were identified, and 204 full-text manuscripts were included after abstract screening (Figure). Data from 81 RCTs were included: 24, 39 and 18 in patients with CKD with/without T2D, CKD with T2D and CKD without T2D, respectively.

Conclusion: as anticipated, differences in the inclusion of patients with/without T2D between studies make comparisons difficult. Future work will compare additional relevant study characteristics, with further insights available in October 2020.

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