Association of Renal and Cardiovascular Safety With DPP- 4 Inhibitors vs. Sulfonylureas in Patients With Type 2 Diabetes and Advanced Chronic Kidney Disease

This study assessed the effects of dipeptidyl peptidase-4 inhibitors (DPP4is) vs. sulfonylureas (SUs) on composite renal, cardiovascular, and hospitalized hypoglycemia outcomes in type 2 diabetes (T2D) patients with advanced chronic kidney disease (CKD) who were underrepresented previous clinical studies. The National Health Insurance Research Database was utilized. Patients T2D CKD (stages 3b-5) stable use DPP4is or SUs identified during 2011-2015 followed until death December 31, 2016. primary outcome renal outcome. Secondary included heart failure (HHF), major adverse cardiovascular event (MACE), hypoglycemia, all-cause death. Subdistribution hazard models employed to assess treatment outcomes. A total 1,204 matched pairs DPP4i SU users analyzed. Compared SUs, had no significant difference risks outcome, HHF, three-point four-point MACE (hazard ratios (95% confidence intervals): 1.10 (0.93-1.31), 1.11 (0.95-1.30), 0.97 (0.79-1.19), 1.08 (0.94-1.24), respectively), but reduced (0.53 (0.43-0.64)) (0.71 (0.53-0.96)). In conclusion, among CKD, associated comparable safety profiles outcomes, may be preferred for regular monitoring cardiac function remains crucial this population are at a higher risk HHF.