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2017 ; 8
(32
): 53028-53040
Nephropedia Template TP
gab.com Text
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English Wikipedia
Dipeptidyl peptidase 4 inhibitor use is associated with a lower risk of incident
acute kidney injury in patients with diabetes
#MMPMID28881791
Chao CT
; Wang J
; Wu HY
; Chien KL
; Hung KY
Oncotarget
2017[Aug]; 8
(32
): 53028-53040
PMID28881791
show ga
OBJECTIVES: Dipeptidyl peptidase 4 inhibitor (DPP4i) use potentially slows the
progression of diabetic kidney disease, but its effects on the risk of acute
kidney injury (AKI) are unclear. We aimed to assess the association between DPP4i
use and incident AKI episodes from a nationally representative cohort in Taiwan.
MATERIALS AND METHODS: All patients newly diagnosed with diabetes mellitus (DM)
between 2008, when DPP4i use was first approved in Taiwan, and mid-2013 were
enrolled. Propensity score-matched diabetic DPP4i users, who received DPP4i for
at least 90 days, and nonusers were selected. The primary and secondary outcomes
were incident AKI and dialysis-requiring AKI during follow-up. Cox proportional
hazard analyses were performed to examine the effect of DPP4i on the risk of AKI.
RESULTS: We enrolled 923,936 diabetic patients; of these, 83,638 DPP4i users
(75.7% sitagliptin, 14.6% vildagliptin, and 9.7% saxagliptin) were propensity
score-matched to 83,638 non-users. After an average 3.6-year follow-up, 1.56% and
0.35% of DPP4i users and 2.53% and 0.56% of non-users developed incident AKI and
dialysis-requiring AKI, respectively. DPP4i use was significantly associated with
lower risk of incident AKI (hazard ratio [HR] 0.57, 95% confidence interval [CI]
0.53-0.61) and risk of dialysis-requiring AKI (HR 0.57, 95% CI 0.49-0.66). The
risk reduction was consistent regardless of DPP4i type, the presence of chronic
kidney disease, the previous acute kidney injury, and age. CONCLUSIONS: DPP4i use
is associated with reduced risk of mild and severe forms of AKI among patients
with incident DM. DPP4i may be an important class of anti-glycaemic agent with
reno-protective effects.