AUTHOR=Rong Xi , Zhu Yawen , Wen Bo , Liu Kai , Li Xinran , Gou Qiling , Chen Xiaoping 

TITLE=Risk of hypovolemia associated with sodium–glucose cotransporter-2 inhibitors treatment: A meta-analysis of randomized controlled trials

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.973129

DOI=10.3389/fcvm.2022.973129

ISSN=2297-055X

ABSTRACT=<sec><title>Aim of the review</title><p>To assess the risk of hypovolemia for sodium–glucose cotransporter-2 (SGLT2) inhibitors treatment.</p></sec><sec><title>Method</title><p>A systematic literature retrieval was performed in PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Scopus from inception up to 4 October 2022, Data for study characteristics and outcomes of interest were extracted from each eligible study. Risk ratios (RRs) with a 95% confidence interval (CI) for hypovolemia were calculated using a random-effect model.</p></sec><sec><title>Results</title><p>A total of 57 studies (<italic>n</italic> = 68,622) were included in our meta-analysis, with a result of 1,972 hypovolemia incidents (1,142 in the SGLT2 inhibitors group and 830 in the control group). The pooled RR was 1.12 (95% CI: 1.02–1.22). It is evident that receiving SGLT2 inhibitors increased the risk of hypovolemia. When stratified by category of SGLT2 inhibitors the result was consistent; when the subgroup was analyzed by age, the pooled RR was 1.07 (95% CI: 0.94–1.23) in patients aged ≥65 years and 1.14 (95% CI: 1.02–1.28) in those aged &lt;65 years. When comparing the baseline estimated glomerular filtration rate (eGFR) of less than or equal to 60 mL/min/1.73 m<sup>2</sup> with a baseline eGFR greater than 60 mL/min/1.73 m<sup>2</sup>, the pooled RR was 1.21, (95% CI: 1.00–1.46) and 1.08, (95%CI: 0.98–1.20), respectively.</p></sec><sec><title>Conclusion</title><p>Our meta-analysis has demonstrated that SGLT2 inhibitors increased the risk of hypovolemia in patients with Type 2 Diabetes Mellitus (T2DM). It is necessary to pay attention to the risk of hypovolemia associated with SGLT2 inhibitors, especially in older individuals and those with moderate renal impairment.</p></sec><sec><title>Systematic review registration</title><p>[<ext-link ext-link-type="uri" xlink:href="https://www.crd.york.ac.uk/prospero/" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.crd.york.ac.uk/prospero/</ext-link>], identifier [CRD42020156254].</p></sec>