The association between anti-inflammatory therapies and renal outcomes in patients with established cardiovascular disease or high cardiovascular risks: a meta-analysis of randomised controlled trials

Background: To assess the relationship between anti-inflammatory therapy and renal events risk in participants with cardiovascular risks or diagnosed cardiovascular disease (CVD). Methods: Literature searches were carried out in PubMed, Embase, clinicaltrial.gov and the Cochrane Central Register of Controlled Trials. Randomised controlled trials that were published from January 1995 to July 2024, compared anti-inflammatory therapy and placebo in participants at cardiovascular risks or with diagnosed CVD and with reports of renal outcomes were included. The results were shown as risk ratio (RR) and 95% confidence interval (CI). Results: In comparison to placebo, therapies targeting inflammation did not exhibit a significant association with the risk of composite renal outcomes (worsening of renal function, death due to kidney disease and end-stage renal disease) (RR = 0.89, 95% CI 0.40 to 1.99, I² = 0%). The risk of worsening of renal function (RR = 0.81, 95% CI 0.21 to 3.07, I² = NA), end-stage renal disease (RR = 0.94, 95% CI 0.31 to 2.85, I² = 0%), death due to kidney disease (RR = 3.00, 95% CI 0.12 to 73.56, I² = NA), chronic kidney disease (RR = 1.77, 95% CI 0.74 to 4.23, I² = 0%), chronic renal failure (RR = 1.70, 95% CI 0.56 to 5.15, I² = 61%) and acute kidney injury (RR = 1.16, 95% CI 0.95 to 1.42, I² = 0%) showed no significant difference between patients receiving anti-inflammatory therapy and placebo. Conclusion: Current evidence did not indicate associations between anti-inflammatory therapies and adverse renal events risks in patients with cardiovascular risks or established CVD. Future researches are needed to explore the renal effects of anti-inflammatory therapy.