Efetividade dos inibidores dos produtos finais da glicação avançada na prevenção da progressão da nefropatia diabética
Arquivos
Data
2007
Autores
Lemos, André Luis Alves de 
Orientadores
Higa, Elisa Mieko Suemitsu
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: O propósito desta revisão sistemática foi avaliar a progressão
da nefropatia diabética em indivíduos recebendo inibidores dos produtos
finais da glicação avançada. Métodos: Tipos de estudos: ensaios clínicos randomizados; tipos de participantes: pacientes com nefropatia diabética (estágios 1 a 4); intervenção: uso dos inibidores dos produtos finais da glicação avançada associado à terapia convencional (inibidores da enzima conversora de angiotensina e/ou antagonistas do receptor da angiotensina II e/ou qualquer outra droga anti-hipertensiva); desfechos: duplicação dos valores da creatinina sérica, retardo na indicação de diálise, mortalidade, clearance da creatinina, proteinúria, albuminúria e taxa de filtração glomerular. Estratégia de busca: a) bases de dados eletrônicos: EMBASE; LILACS; MEDLINE; Cochrane library; b) busca manual; c) comunicação pessoal; d) contactos com indústria farmacêutica. Resultados: foram encontrados quatro estudos, porém somente um preencheu os critérios de inclusão. O desfecho principal deste estudo foi a duplicação da creatinina sérica, favorável ao grupo experimental, porém estatisticamente não significante, risco relativo (RR) de 0,78, intervalo de confiança (IC) de 0,55 a 1,03. No desfecho mortalidade não houve redução com significância estatística entre os grupos, RR de 1,33 e IC de 0,58 à 3,07. No desfecho retardo na indicação da diálise também não houve redução com significância estatística com RR de 1,06 e IC de 0,71 à 1,59. Conclusão: Nos dados apresentados não existem evidências para utilização dos inibidores dos produtos finais da glicação avançada na prevenção da progressão da nefropatia diabética.
Objective: The purposal of this systematic review was to assess the effectiveness of advanced glycation end products inhibitors in association to standard therapy on slowering the progression of diabetic kidney disease. Methods:- type of studies: all eligible randomized clinical trials; type of participants: diabetic individuals (type 1 or 2) with kidney disease (1,2,3,4 stages); intervention: advanced glycation end products inhibitors; outcomes: mortality, creatine clearance, doubling of serum creatinine, albuminuria, proteinuria, glomerular filtration rate (GFR), rate of decline of GFR and onset of dialysis. Strategy search: a) online database: EMBASE; LILACS; MEDLINE; Cochrane Library; b) manual search; c)personal communication; d) pharmaceutical industry contact. Two reviewers, independent, evaluated the references found with the search strategy and applied the inclusion criteria. The methodological quality of the selected assays was done according to Cochrane’s Handbook. After collecting all eligible assays, it was not possible to summarize data into a metanalysis. Results: applying the search strategies we identified four trials. Only one study met the inclusion criteria. The main outcome was doubling of serum creatinine, favourable to experimental group but without statistical significance, relative risk (RR) = 0,78, confidence interval (CI) = 0,55 to 1,03). On mortality there was no difference between groups, RR=1,33, CI 0,58-3,07. On the outcome progression to ESRD there was no difference too, RR=1,06 and CI = 0,71 to 1,59. Conclusions: Until now, according to data identified, there is no evidence that allows the clinical use of AGE inhibitors in diabetic kidney.
Objective: The purposal of this systematic review was to assess the effectiveness of advanced glycation end products inhibitors in association to standard therapy on slowering the progression of diabetic kidney disease. Methods:- type of studies: all eligible randomized clinical trials; type of participants: diabetic individuals (type 1 or 2) with kidney disease (1,2,3,4 stages); intervention: advanced glycation end products inhibitors; outcomes: mortality, creatine clearance, doubling of serum creatinine, albuminuria, proteinuria, glomerular filtration rate (GFR), rate of decline of GFR and onset of dialysis. Strategy search: a) online database: EMBASE; LILACS; MEDLINE; Cochrane Library; b) manual search; c)personal communication; d) pharmaceutical industry contact. Two reviewers, independent, evaluated the references found with the search strategy and applied the inclusion criteria. The methodological quality of the selected assays was done according to Cochrane’s Handbook. After collecting all eligible assays, it was not possible to summarize data into a metanalysis. Results: applying the search strategies we identified four trials. Only one study met the inclusion criteria. The main outcome was doubling of serum creatinine, favourable to experimental group but without statistical significance, relative risk (RR) = 0,78, confidence interval (CI) = 0,55 to 1,03). On mortality there was no difference between groups, RR=1,33, CI 0,58-3,07. On the outcome progression to ESRD there was no difference too, RR=1,06 and CI = 0,71 to 1,59. Conclusions: Until now, according to data identified, there is no evidence that allows the clinical use of AGE inhibitors in diabetic kidney.
Descrição
Citação
São Paulo: [s.n.], 2007. 62 p.