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자료유형
학술저널
저자정보
배재현 (고려대학교안암병원)
저널정보
대한내분비학회 Endocrinology and Metabolism Endocrinology and Metabolism Vol.34 No.1
발행연도
2019.1
수록면
80 - 92 (13page)

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Background: To investigate the effects of dipeptidyl peptidase-4 (DPP-4) inhibitors on renal outcomes in patients with type 2 diabetes. Methods: MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched to identify randomized controlled trials (RCTs) of DPP-4 inhibitors from inception to September 2017. We selected eligible RCTs comparing DPP-4 inhibitorswith placebo or other antidiabetic agents and reporting at least one renal outcome. A meta-analysis was conducted to calculate standardized mean differences, weighted mean differences (WMDs), relative risks (RRs), and 95% confidence intervals (CIs) for eachrenal outcome. Results: We included 23 RCTs with 19 publications involving 41,359 patients. Overall changes in urine albumin-to-creatinine ratiowere comparable between DPP-4 inhibitors and controls (P=0.150). However, DPP-4 inhibitors were associated with significantlylower risk of incident microalbuminuria (RR, 0.89; 95% CI, 0.80 to 0.98; P=0.022) and macroalbuminuria (RR, 0.77; 95% CI, 0.61to 0.97; P=0.027), as well as higher rates of regression of albuminuria (RR, 1.22; 95% CI, 1.10 to 1.35; P<0.001) compared withcontrols. Although DPP-4 inhibitors were associated with small but significantly lower estimated glomerular filtration rate (WMD,−1.11 mL/min/1.73 m2; 95% CI, −1.78 to −0.44; P=0.001), there was no difference in the risk of end-stage renal disease betweentwo groups (RR, 0.93; 95% CI, 0.76 to 1.14; P=0.475). Conclusion: DPP-4 inhibitors had beneficial renal effects mainly by reducing the risk of development or progression of albuminuriacompared with placebo or other antidiabetic agents.

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