Dipeptidyl peptidase 4 inhibitors reduce the risk of adverse outcomes after acute kidney injury in diabetic patients

被引：1

作者：

Liao, Hung-Wei ^{[1
,2
]}

Cheng, Chung-Yi ^{[1
,2
,3
]}

Chen, Hsing-Yu ^{[4
,5
,6
]}

Chen, Jui-Yi ^{[7
,8
]}

Pan, Heng-Chih ^{[9
,10
,11
,12
]}

Huang, Tao-Min ^{[13
]}

Wu, Vin-Cent ^{[14
,15
,16
]}

机构：

[1] Taipei Med Univ, Wan Fang Hosp, Dept Internal Med, Div Nephrol, Taipei, Taiwan

[2] Taipei Med Univ, Coll Med, Sch Med, Dept Internal Med,Div Nephrol, Taipei, Taiwan

[3] Taipei Med Univ, Taipei Med Univ Res Ctr Urol & Kidney RCUK, Coll Med, Sch Med, Taipei, Taiwan

[4] Chang Gung Univ, Grad Inst Clin Med Sci, Coll Med, Taoyuan, Taiwan

[5] Chang Gung Mem Hosp, Ctr Tradit Chinese Med, Div Chinese Internal Med, Taoyuan, Taiwan

[6] Chang Gung Univ, Coll Med, Sch Tradit Chinese Med, Taoyuan, Taiwan

[7] Chi Mei Med Ctr, Dept Internal Med, Div Nephrol, Tainan, Taiwan

[8] Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr, Tainan, Taiwan

[9] Natl Taiwan Univ, Grad Inst Clin Med, Coll Med, Taipei, Taiwan

[10] Chang Gung Univ, Coll Med, Taoyuan, Taiwan

[11] Keelung Chang Gung Mem Hosp, Dept Internal Med, Div Nephrol, Keelung, Taiwan

[12] Keelung Chang Gung Mem Hosp, Community Med Res Ctr, Keelung, Taiwan

[13] Natl Taiwan Univ Hosp, Dept Internal Med, Div Nephrol, Taipei, Taiwan

[14] Natl Taiwan Univ Hosp, Primary Aldosteronism Ctr, Dept Internal Med, Taipei, Taiwan

[15] TAIPAI Taiwan Primary Aldosteronism Investigators, NSARF Natl Taiwan Univ Hosp Study Grp ARF, Taipei, Taiwan

[16] CAKS Taiwan Consortium Acute Kidney Injury & Renal, Taipei, Taiwan

来源：

CLINICAL KIDNEY JOURNAL | 2025年 / 18卷 / 02期

关键词：

acute kidney disease; acute kidney injury; dipeptidyl peptidase 4 inhibitors; major adverse kidney events; mortality; DPP-4; INHIBITORS; DISEASE; MORTALITY;

D O I：

10.1093/ckj/sfae385

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background Dipeptidyl peptidase 4 inhibitors (DPP4is) are considered safe for use in patients with diabetes mellitus and kidney dysfunction. We explored whether usage of DPP4is in patients who recovered from dialysis-requiring acute kidney injury (AKI) could reduce the risk of future cardiac and kidney events.Methods We used the TriNetX platform to investigate whether the use of DPP4is in diabetes mellitus patients within 90 days of discharge from acute kidney disease could reduce the risk of all-cause mortality, major adverse kidney events (MAKEs), major adverse cardiovascular events (MACEs), and re-dialysis. The patients were followed for 5 years or until the occurrence of significant outcomes, with cohort data collected from 1 January 2016 to 30 September 2022.Results The cohort utilizing DPP4is comprised 7348 patients with acute kidney disease, while the control group encompassed 229 417 individuals. After applying propensity score matching, 7343 patients (age 66.2 +/- 13.4 years; male, 49.9%) who used DPP4is showed a significant reduction in the risk of all-cause mortality [adjusted hazard ratio (aHR) 0.89; E-value 1.50 , MAKEs (aHR 0.86; E-value 1.59), MACEs (aHR 0.91; E-value 1.44), and re-dialysis (aHR 0.73; E-value 2.10) after a median follow-up of 2.4 years.Conclusions We demonstrated that in diabetes mellitus patients concurrently experiencing acute kidney disease, DPP4i usage could decrease the risk of mortality, MAKEs, MACEs, and re-dialysis. These findings emphasize the pivotal role of tailored treatment strategies involving DPP4i for acute kidney disease patients.

引用

页数：9

共 37 条

[1] Mean Difference, Standardized Mean Difference (SMD), and Their Use in Meta-Analysis: As Simple as It Gets [J].