Division of Nephrology and Endocrinology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Diabetes Obes Metab. 2024 Oct;26(10):4460-4467. doi: 10.1111/dom.15800. Epub 2024 Jul 31.
To evaluate the renal prognosis of dipeptidyl peptidase-4 inhibitor (DPP-4i) users and non-users using real-world Asian data.
Using databases from DeSC Healthcare, Inc., patients aged 30 years or older who used antidiabetic drugs from 2014 to 2021 were identified. Propensity score matching analyses were used to compare renal prognosis between DPP-4i users and non-users. The primary outcomes were estimated glomerular filtration rate (eGFR) decline and end-stage kidney disease (ESKD) development in the eGFR of 45 mL/min/1.73m or higher and eGFR of less than 45 mL/min/1.73m groups, respectively.
In total, 65 375 and 9866 patients were identified in the eGFR of 45 mL/min/1.73m or higher and eGFR of less than 45 mL/min/1.73m groups, respectively. In the eGFR of 45 mL/min/1.73m or higher group, propensity score matching created 16 002 pairs. A significant difference was observed in the primary outcome of eGFR decline between DPP-4i users and non-users at 2 years (-2.31 vs. -2.56 mL/min/1.73m: difference, 0.25 mL/min/1.73m; 95% confidence interval [CI], 0.06-0.44) and 3 years (-2.75 vs. -3.41 mL/min/1.73m: difference, 0.66 mL/min/1.73m; 95% CI, 0.39-0.93). In the eGFR less than 45 mL/min/1.73m group, propensity score matching created 2086 pairs. After a mean of 2.2 years of observation, ESKD development was 1.15% and 2.30% in users and non-users, respectively, and Kaplan-Meier analysis revealed a significant difference (log rank P = .005).
This retrospective real-world study revealed that patients using DPP-4is had a better renal prognosis than those not using DPP-4is.
利用真实亚洲数据评估二肽基肽酶-4 抑制剂（DPP-4i）使用者和非使用者的肾脏预后。
利用 DeSC Healthcare, Inc. 的数据库，确定了 2014 年至 2021 年期间使用抗糖尿病药物的年龄在 30 岁或以上的患者。采用倾向评分匹配分析比较 DPP-4i 使用者和非使用者的肾脏预后。主要结局分别为 eGFR（肾小球滤过率）下降和 eGFR 为 45 mL/min/1.73m2 或更高以及 eGFR 小于 45 mL/min/1.73m2 组中终末期肾病（ESKD）的发展。
eGFR 为 45 mL/min/1.73m2 或更高组和 eGFR 小于 45 mL/min/1.73m2 组分别确定了 65375 例和 9866 例患者。在 eGFR 为 45 mL/min/1.73m2 或更高组中，进行了倾向评分匹配，创建了 16002 对。DPP-4i 使用者和非使用者在 2 年（-2.31 与-2.56 mL/min/1.73m2：差异，0.25 mL/min/1.73m2；95%置信区间[CI]，0.06-0.44）和 3 年（-2.75 与-3.41 mL/min/1.73m2：差异，0.66 mL/min/1.73m2；95% CI，0.39-0.93）时 eGFR 下降的主要结局存在显著差异。在 eGFR 小于 45 mL/min/1.73m2 组中，进行了倾向评分匹配，创建了 2086 对。经过平均 2.2 年的观察，使用者和非使用者的 ESKD 发生率分别为 1.15%和 2.30%，Kaplan-Meier 分析显示差异有统计学意义（对数秩检验 P=0.005）。
这项回顾性真实世界研究表明，使用 DPP-4i 的患者肾脏预后优于未使用 DPP-4i 的患者。
