Clinical Innovations, Medco Health Solutions, Franklin Lakes, New Jersey, USA.
Diabetes Obes Metab. 2012 Jul;14(7):596-600. doi: 10.1111/j.1463-1326.2012.01567.x. Epub 2012 Feb 20.
This study evaluated whether the risk of acute renal failure (ARF) increases with exenatide and sitagliptin use.
A retrospective cohort study of a large medical and pharmacy claims database was performed. Data for 4 91 539 patients were analysed. Cox proportional hazard models were used to compare the risk of ARF between diabetic and non-diabetic subjects and between diabetic patients treated with exenatide, sitagliptin and control medications.
Adjusted Cox analyses showed diabetic subjects had a higher risk of ARF [HR 1.51, confidence interval (CI) 1.26-1.81, p < 0.001] than non-diabetic controls. Compared with diabetic controls, neither exenatide (HR 0.77, CI 0.42-1.41, p = 0.40) nor sitagliptin (HR 1.17, CI 0.82-1.65, p = 0.39) increased the risk of ARF.
Our study revealed an increased incidence of ARF in diabetic versus non-diabetic patients but no association between use of exenatide or sitagliptin and ARF. Because of the limitations of this observational analysis, we cannot exclude the possibility of a very small increased risk.
本研究评估了艾塞那肽和西他列汀的使用是否会增加急性肾衰竭（ARF）的风险。
对一个大型医疗和药房理赔数据库进行了回顾性队列研究。对 491539 名患者的数据进行了分析。采用 Cox 比例风险模型比较了糖尿病和非糖尿病患者以及接受艾塞那肽、西他列汀和对照药物治疗的糖尿病患者之间发生 ARF 的风险。
调整后的 Cox 分析显示，与非糖尿病对照组相比，糖尿病患者发生 ARF 的风险更高[风险比（HR）1.51，置信区间（CI）1.26-1.81，p<0.001]。与糖尿病对照组相比，艾塞那肽（HR 0.77，CI 0.42-1.41，p=0.40）和西他列汀（HR 1.17，CI 0.82-1.65，p=0.39）均未增加 ARF 的风险。
我们的研究显示，与非糖尿病患者相比，糖尿病患者发生 ARF 的发生率增加，但艾塞那肽或西他列汀的使用与 ARF 之间没有关联。由于这种观察性分析的局限性，我们不能排除风险略有增加的可能性。
