服用非奈利酮对糖尿病肾病患者血清钾水平影响的系统评价OACSTPCD

Objective To systematically evaluate the effect of finerenone on serum potassium in diabetic nephropa-thy patients.Methods CNKI,Chinese Science and Technology Journal Database(VIP),Wanfang Database,PubMed,Web of Science,Embase and Cochrane Library were searched by computer until October 12,2023 for randomized con-trolled trials(RCT)of finerenone in the treatment of diabetic nephropathy.Cochrane systematic review tool was used to evaluate literature quality.The data were extracted,including the baseline characteristics of the subjects(trial group,the number of people,age,baseline serum potassium level,etc.),intervention measures,and outcome indicators of in-terest(changes in serum potassium from baseline,incidence of hyperkalemia,discontinuation of the trial due to hyperka-lemia,etc.).RevMan5.4 software was used for Meta-analysis.Results A total of 5 RCTS involving 14 182 patients were included in this study.Patients in the treatment group were treated with finerenone,and the control group with pla-cebo.Meta-analysis results showed that:compared with the control group,the treatment group had a greater increase in serum potassium concentration[MD=0.14,95%CI(0.05-0.23),P<0.01]and a higher incidence of hyperkalemia[OR=2.21,95%CI(1.96-2.49),P<0.00001],and higher incidences of moderate and severe hyperkalemia[OR=2.43,95%CI(2.17-2.71),P<0.01;OR=2.60,95%CI(2.01-3.35),P<0.01];when the follow-up time was more than 3 months,the incidence of hyperkalemia in the treatment group was higher[OR=2.21,95%CI(1.96-2.49),P<0.01].Conclusion Taking finerenone can increase the serum potassium level of diabetic nephropathy patients,and the inci-dence of hyperkalemia increases.