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接受二肽基肽酶 4 抑制剂治疗的患者发生急性肾损伤的几率:退伍军人事务部内的一项全国队列研究。

Odds of Acute Kidney Injury in Patients Receiving Dipeptidyl Peptidase 4 Inhibitors: A National Cohort Study Within the Department of Veterans Affairs.

机构信息

College of Pharmacy, Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina, Columbia, South Carolina, USA.

Dorn Research Institute, WJB Dorn Veterans Affairs Medical Center, Columbia, South Carolina, USA.

出版信息

Clin Transl Sci. 2019 Nov;12(6):698-703. doi: 10.1111/cts.12676. Epub 2019 Aug 17.

Abstract

Preclinical and clinical data of dipeptidyl peptidase 4 (DPP-4) inhibitors have demonstrated discordant data regarding acute kidney injury (AKI). Therefore, we aimed to evaluate the association between DPP-4 use and AKI. This cohort study utilized data from the Department of Veterans Affairs evaluating patients diagnosed with type 2 (T2) diabetes with a DPP-4 inhibitor and compared with nondiabetic and diabetic patients. The primary end point is the development of AKI, and statistical analyses were performed to examine the association. DPP-4 use is associated with a lower odds of AKI compared with diabetics (adjusted odds ratio (OR) = 0.39; 95% confidence interval (CI) = 0.32-0.48) and nondiabetics (OR = 0.64; 95% CI = 0.52-0.79). DPP-4 use in patients with T2 diabetes mellitus is associated with lower odds of AKI within 120 days compared with nondiabetic and diabetic controls when adjusting for study covariates.

摘要

二肽基肽酶 4(DPP-4)抑制剂的临床前和临床数据表明,其与急性肾损伤(AKI)之间的数据存在不一致。因此,我们旨在评估 DPP-4 抑制剂的使用与 AKI 之间的关系。这项队列研究利用了美国退伍军人事务部的数据,评估了患有 2 型(T2)糖尿病且使用 DPP-4 抑制剂的患者,并与非糖尿病患者和糖尿病患者进行了比较。主要终点是 AKI 的发生,进行了统计分析以检验相关性。与糖尿病患者(调整后的优势比(OR)=0.39;95%置信区间(CI)=0.32-0.48)和非糖尿病患者(OR=0.64;95%CI=0.52-0.79)相比,DPP-4 抑制剂的使用与 AKI 的发生几率较低相关。在调整了研究协变量后,与非糖尿病和糖尿病对照组相比,T2 糖尿病患者在 120 天内使用 DPP-4 抑制剂与 AKI 发生几率较低相关。

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Acute Kidney Injury in Diabetes Mellitus.糖尿病中的急性肾损伤
Int J Nephrol. 2016;2016:6232909. doi: 10.1155/2016/6232909. Epub 2016 Nov 15.

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