According to a prospective nationwide cohort study conducted by Dr. Chia-Ter Chao, a nephrologist in National Taiwan University Hospital, and collaborated with professor Kuo-Liong Chien, professor Kuan-Yu Hung, and one PhD student, Mr. Jui Wang, at the College of Public Health in National Taiwan University, diabetic users of one important class of oral anti-diabetic drugs, dipeptidyl peptidase 4 inhibitor (DPP4i), may have a lower risk of developing acute kidney injury (AKI) than non-users. This study has been published in the journal, Oncotarget (http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=view&path=18081 ).
“DPP4i has long been considered to exhibit pleiotropic effect besides its anti-hyperglycemic potential; however, whether this effect extends to renal outcome such as AKI is unclear.” said Dr. Chao and Mr. Wang, the equal first author of the article who has accomplished this study together.
The researchers utilized the Taiwan Health Insurance research Database to construct the cohort of diabetic DPP4i users and another cohort of propensity score-matched controls, with incident AKI and dialysis-requiring AKI events as the primary and the secondary outcomes.
A total of 923,936 incident diabetic patients were recruited, among whom 83,638 DPP4i users (75.7 percent sitagliptin, 14.6 percent vildagliptin, and 9.7 percent saxagliptin) and non-users entered into analysis. After an average 3.6-year of follow up, DPP4i users had a nearly halving of their risk of developing AKI and dialysis requiring AKI compared with non-users. The risk reduction was consistent across various age group, DPP4i types, and chronic kidney disease status.
The finding of the representative cohort study suggests that DPP4i may be an important class of anti-glycemic agent with potential reno-protective effects in real-world experience. Future studies with a prospective design and laboratory parameters-based diagnosis of AKI are warranted to validate this hypothesis.Tags: Taiwan