{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T04:04:25Z","timestamp":1789358665001,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T00:00:00Z","timestamp":1789257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T00:00:00Z","timestamp":1789257600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>While the new kidney protective therapies have transformed chronic kidney disease (CKD) management in patients with Type 2 diabetes mellitus (T2DM), treatment options for CKD in Type 1 diabetes mellitus (T1DM) have remained unchanged for 30\u2009years, limited to renin\u2013angiotensin system inhibitors (RASis). Given similarities in pathophysiology between CKD in T1DM and T2DM, we conducted a systematic review and meta\u2010analysis evaluating sodium\u2013glucose cotransporter\u20102 inhibitors (SGLT\u20102is), mineralocorticoid receptor antagonists (MRAs) and glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RAs) on kidney function, albuminuria and safety outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We searched Medline, EMBASE, Cochrane CENTRAL, CINAHL, Global Health, LILACS and Scopus from inception until 11 April 2025, for randomised controlled trials (RCTs) evaluating RASi, MRAs, GLP\u20101RAs and SGLT\u20102is on change in urine albumin\u2010to\u2010creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) in adults (age \u2265\u200918) with T1DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 7151 unique records were identified and 41 RCTs were included in the meta\u2010analysis. No RCTs evaluating nsMRAs or MRAs met our inclusion criteria. Treatment with SGLT\u20102i or RASi was associated with a 45% reduction in UACR versus placebo (GMR\u2009=\u20090.55; 95% CI: 0.32\u20130.94). No difference in the annual rate of eGFR change was observed across drug classes compared to placebo (mean difference 1.16\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      \/year; 95% CI: \u22120.38 to 2.70). Treatment was associated with a higher risk of hypoglycaemia (RR\u2009=\u20091.03; 95% CI: 1.01\u20131.05) and DKA (RR\u2009=\u20091.97; 95% CI: 1.33\u20132.93).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with T1DM, the pooled analysis showed a reduction in UACR overall, but that this appeared to be driven predominantly by the SGLT\u20102i studies, with limited and non\u2010significant evidence in the RAS inhibitor subgroup. Dedicated RCTs in the T1DM population could help establish the efficacy and safety of these different drug classes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO registration: CRD420261352699.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71337","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T03:53:41Z","timestamp":1789358021000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Renin\u2013Angiotensin Inhibitors, Sodium\u2013Glucose Cotransporter 2 Inhibitors, Mineralocorticoid Receptor Antagonists and Glucagon\u2010Like Peptide 1 Receptor Agonists on Kidney Outcomes in Patients With Type 1 Diabetes: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","author":[{"given":"Frances","family":"Perry","sequence":"first","affiliation":[{"name":"Internal Medicine University of Manitoba College of Medicine  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0006-9596","authenticated-orcid":false,"given":"Silvia J.","family":"Leon","sequence":"additional","affiliation":[{"name":"Chronic Disease Innovation Centre (CDIC)  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Polecina","sequence":"additional","affiliation":[{"name":"Chronic Disease Innovation Centre (CDIC)  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6986-1386","authenticated-orcid":false,"given":"Ruth","family":"Getachew","sequence":"additional","affiliation":[{"name":"Chronic Disease Innovation Centre (CDIC)  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Askin","sequence":"additional","affiliation":[{"name":"Neil John Maclean Health Sciences Libraries University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Internal Medicine University of Manitoba College of Medicine  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7046-0358","authenticated-orcid":false,"given":"Reid","family":"Whitlock","sequence":"additional","affiliation":[{"name":"Chronic Disease Innovation Centre (CDIC)  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihe","family":"Zheng","sequence":"additional","affiliation":[{"name":"US Medical Affairs, Bayer US LLC  Whippany New Jersey 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 Winnipeg Manitoba Canada"},{"name":"Chronic Disease Innovation Centre (CDIC)  Winnipeg Manitoba 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