No. of studies	Risk of bias	Inconsistency	Indirectness	Imprecision	Other considerations	Certainty	Proportion of events		Relative effects (95% CI)	Absolute effects
							Intervention	Control
Renal death
Metformin
3625 (1 RCT)	Not serious	Not serious	Not serious	VERY seriousb	none	⨁⨁◯◯ LOW	9/3283 (0.3%)	2/342 (0.6%)	OR 2.14 (0.46 to 9.94)	3 per 1.000	3 higher per 1.000 (from 1 lower to 24 higher)
Pioglitazone
–	–	–	–	–	–	–	–	–	–	–	–
Insulin-secretagogues
10,472 (3 RCTs)	Not seriousc	Not serious	Not serious	Seriousa	None	⨁⨁⨁◯ MODERATE	12/5820 (0.2%)	19/4652 (0.4%)	OR 2.02 (0.97 to 4.21)	2 per 1.000	2 higher per 1.000 (from 0 lower to 7 higher)
DPP-4i
32,368 (8 RCTs)	Not serious	Not serious	Not serious	Not serious	None	⨁⨁⨁⨁ HIGH	15/16465 (0.1%)	11/15903 (0.1%)	OR 0.87 (0.39 to 1.93)	1 per 1.000	0 lower per 1.000 (from 1 lower to1 higher)
GLP-1 RA
26,025 (4 RCTs)	Not serious	Not serious	Not serious	Seriousa	None	⨁⨁⨁◯ MODERATA	11/12924 (0.1%)	13/13101 (0.1%)	OR 1.19 (0.53 to 2.66)	1 per 1.000	0 higher per 1.000 (from 0 lower to 1 higher)
SGLT-2i
v	Not serious	Not serious	Not serious	Not serious	Very strong association	⨁⨁⨁⨁ HIGH	317/21655 (1.5%)	228/28220 (0.8%)	OR 0.67 (0.56 to 0.80)	15 per 1.000	5 lower per 1.000 (from 6 lower to3 lower)
Alpha-glucosidase inhibitors
–	–	–	–	–	–	–	–	–	–	–	–
Insulin
–	–	–	–	–	–	–	–	–	–	–	–