Comparative efficacy of lipid-lowering therapies on the cardio-renal-metabolic axis in diabetic kidney disease: a Bayesian network meta-analysis addressing residual CRM risk.
J, L., Y, D., C, W., C, L., J, S., J, Q., S, H., Y, A., L, W., & P, L. (2026). Comparative efficacy of lipid-lowering therapies on the cardio-renal-metabolic axis in diabetic kidney disease: a Bayesian network meta-analysis addressing residual CRM risk.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1842847
J L, Y D, C W, C L, J S, J Q, et al. Comparative efficacy of lipid-lowering therapies on the cardio-renal-metabolic axis in diabetic kidney disease: a Bayesian network meta-analysis addressing residual CRM risk.. Frontiers in endocrinology. 2026; doi: 10.3389/fendo.2026.1842847
J L, Y D, C W, et al. Comparative efficacy of lipid-lowering therapies on the cardio-renal-metabolic axis in diabetic kidney disease: a Bayesian network meta-analysis addressing residual CRM risk.[J]. Frontiers in endocrinology. 2026. DOI: 10.3389/fendo.2026.1842847.
@article{j2026,
author = {Luo J and Dai Y and Wu C and Lan C and Shi J and Qi J and Hua S and An Y and Wang L and Li P},
title = {Comparative efficacy of lipid-lowering therapies on the cardio-renal-metabolic axis in diabetic kidney disease: a Bayesian network meta-analysis addressing residual CRM risk.},
journal = {Frontiers in endocrinology},
year = {2026},
doi = {10.3389/fendo.2026.1842847},
note = {PMID: 42290868},
}
TY - JOUR AU - Luo J AU - Dai Y AU - Wu C AU - Lan C AU - Shi J AU - Qi J AU - Hua S AU - An Y AU - Wang L AU - Li P TI - Comparative efficacy of lipid-lowering therapies on the cardio-renal-metabolic axis in diabetic kidney disease: a Bayesian network meta-analysis addressing residual CRM risk. T2 - Frontiers in endocrinology PY - 2026 DO - 10.3389/fendo.2026.1842847 AN - PMID:42290868 ER -
BACKGROUND: In diabetic kidney disease (DKD), dyslipidemia accelerates renal decline and heart failure risk, making Cardio-Renal-Metabolic (CRM) risk reduction critical. The bidirectional relationship between cardiac and renal dysfunction further highlights the necessity of lipid-lowering therapy as a common intervention pathway; however, its comparative efficacy remains unclear. OBJECTIVE: To compare the Cardio-Renal-Metabolic (CRM) outcomes of various lipid-lowering agents. METHODS: We searched PubMed, Embase, Web of Science, and Cochrane Library for Randomized Controlled Trials (RCTs) up to May 10, 2025; a Bayesian network meta-analysis compared their effects. RESULTS: From 20 RCTs, Cerivastatin best reduced Total Cholesterol (TC) (Mean Difference (MD): -94.03, 95% CI: -185.37 to -2.16), while Simvastatin best lowered Low-Density Lipoprotein Cholesterol (LDL-C) (MD: -56.05, 95% CI: -101.64 to -11.66). For cardiorenal outcomes, Atorvastatin, Rosuvastatin, and Fenofibrate potentially improved Urine Albumin-to-Creatinine Ratio (UACR). Atorvastatin (MD: -3.19, 95% CI: -5.12 to -1.27) and Fenofibrate (MD: -1.44, 95% CI: -2.78 to -0.09) most robustly reduced cardiovascular event rates (CVER) in hyperlipidemic DKD. CONCLUSION: Lipid-lowering agents have divergent effects; Atorvastatin and Fenofibrate best reduce CVER despite variable renal effects, supporting a phenotype-driven CRM strategy prioritizing residual cardiovascular risk reduction. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/, identifier CRD420251049719.