標題: Improvement in Mortality and End-Stage Renal Disease in Patients With Type 2 Diabetes After Acute Kidney Injury Who Are Prescribed Dipeptidyl Peptidase-4 Inhibitors
作者: Chen, Cheng-Yi
Wu, Vin-Cent
Lin, Cheng-Jui
Lin, Chih-Sheng
Pan, Chi-Feng
Chen, Han-Hsiang
Lin, Yu-Feng
Huang, Tao-Min
Chen, Likwang
Wu, Chih-Jen
生物科技學系
Department of Biological Science and Technology
公開日期: 1-Dec-2018
摘要: Objective: To focus on the potential beneficial effects of the pleiotropic effects of dipeptidyl peptidase-4 inhibitors (DPP4is) on attenuating progression of diabetic kidney disease in reducing the long-term effect of the acute kidney injury (AKI) to chronic kidney disease (CKD) transition. Patients and Methods: Data from the National Health Insurance Research Database from January 1, 1999, to July 31, 2011, were analyzed, and patients with diabetes weaning from dialysis-requiring AKI were identified. Cox proportional hazards models and inverse-weighted estimates of the probability of treatment were used to adjust for treatment selection bias. The outcomes were incident end-stage renal disease (ESRD) and mortality, major adverse cardiovascular events, and hospitalized heart failure. Results: Of a total of 6165 patients with diabetes weaning from dialysis-requiring AKI identified, 5635 (91.4%) patients were DPP4i nonusers and 530 (8.6%) patients were DPP4i users. Compared with DPP4i nonusers, DPP4i users had a lower risk of ESRD (hazard ratio, 0.81; 95% CI, 0.70-0.94; P=.04) and all-cause mortality (hazard ratio, 0.28; 95% CI, 0.23-0.34; P<.001) after adjustments for CKD, advanced CKD, and angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker use. In contrast, the risk of major adverse cardiovascular events and hospitalized heart failure did not differ significantly between groups. Conclusion: Dipeptidyl peptidase-4 inhibitor users had a lower risk of ESRD and mortality than did nonusers among patients with diabetes after weaning from dialysis-requiring AKI. Therefore, a prospective study of AKI to CKD transitions after episodes of AKI is needed to optimally target DPP4i interventions. (C) 2018 Mayo Foundation for Medical Education and Research
URI: http://dx.doi.org/10.1016/j.mayocp.2018.06.023
http://hdl.handle.net/11536/148553
ISSN: 0025-6196
DOI: 10.1016/j.mayocp.2018.06.023
期刊: MAYO CLINIC PROCEEDINGS
Volume: 93
起始頁: 1760
結束頁: 1774
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