Evidence mapPaperPMID 40611400Full record

ArticleJournal of internal medicine2025

Use of dipeptidyl peptidase-4 inhibitors is associated with lower risk of severe renal outcomes in pre-dialysis patients with Type 2 diabetes.

Tung-Ying Hung, Tzu-Chieh Lin, Ying-Jay Liou, Tzu-Han Lin, Yu-Juei Hsu, Liang-Yu Lin, Meng-Ting Wang

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Article in Journal of internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Tung-Ying HungDepartment of Pharmacy, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Tzu-Chieh LinDepartment of Pharmacy, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Ying-Jay LiouFaculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Tzu-Han LinDepartment of Pharmacy, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Yu-Juei HsuDepartment of Biochemistry, National Defense Medical Center, Taipei, Taiwan.
Liang-Yu LinDivision of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Meng-Ting WangDepartment of Pharmacy, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesPatients with diabetes and Stage 5 chronic kidney disease (CKD) not on dialysis are susceptible to renal replacement therapy and severe complications. Among limited antidiabetic options in this vulnerable population, dipeptidyl peptidase-4 (DPP-4) inhibitors (DPP-4i) are widely used; however, supporting evidence is scant. This study assessed severe renal outcomes associated with DPP-4i in diabetic and pre-dialysis patients.

methodsThis study employed an active-comparator and propensity score-based inverse probability of treatment weighting approach, using Taiwan's nationwide healthcare claims database from 2012 to 2020. We identified patients with diabetes and CKD stage 5 not on dialysis who received erythropoietin (erythropoietin-stimulating agent), a drug reimbursed for patients with an estimated glomerular filtration rate <15 mL/min/1.73 m

resultsWe included 7271 diabetic and pre-dialysis patients with CKD stage 5, of whom 5028 received DPP-4i and 2243 received meglitinides. DPP-4i were associated with a 14% reduced risk of the renal composite outcome compared to meglitinides (weighted hazard ratio [HR], 0.86; 95% confidence interval, 0.81-0.92). Individual component analysis revealed that the decreased risk was confined to renal replacement therapy, with a 17% reduction. DPP-4i was related to a 41% decreased severe hypoglycemia risk.

conclusionsIn diabetic and pre-dialysis patients with CKD stage 5, DPP-4i are related to a lower risk of the renal composite outcome, primarily driven by lower renal dialysis risk, and a lower hypoglycemia risk compared with meglitinides.

Indexed as

Diabetes Mellitus, Type 2Diabetic NephropathiesDipeptidyl-Peptidase IV InhibitorsRenal Insufficiency, ChronicAgedFemaleGlomerular Filtration RateHumansHypoglycemic AgentsMaleMiddle AgedPropensity ScoreRetrospective StudiesTaiwanDipeptidyl-Peptidase IV InhibitorsHypoglycemic Agentscohort studydialysisdipeptidyl peptidase‐4 inhibitorsend‐stage renal diseaserenal replacement therapy

Identifiers

PMID40611400
PMCPMC12374763

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.