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ID 60377
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Shikata, Kenichi Center for Innovative Clinical Medicine, Okayama University Hospital ORCID Kaken ID publons researchmap
Haneda, Masakazu Division of Metabolism and Biosystemic Science, Department of Medicine, Asahikawa Medical University
Ninomiya, Toshiharu Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
Koya, Daisuke Department of Diabetology & Endocrinology, Kanazawa Medical University
Suzuki, Yoshiki Health Administration Center, Niigata University
Suzuki, Daisuke Suzuki Diabetes Clinic
Ishida, Hitoshi Research Center for Health Care, Nagahama City Hospital
Akai, Hiroaki Division of Metabolism and Diabetes, Tohoku Medical and Pharmaceutical University
Tomino, Yasuhiko Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine
Uzu, Takashi Division of Nephrology, Department of Medicine, Nippon Life Hospital
Nishimura, Motonobu Department of Diabetes and Endocrinology, National Hospital Organization Chiba‐East National Hospital
Maeda, Shiro Department of Advanced Genomic and Laboratory Medicine, Graduate School of Medicine, University of the Ryukyus
Ogawa, Daisuke Okayama Diabetes and Neurology Clinic
Miyamoto, Satoshi Center for Innovative Clinical Medicine, Okayama University Hospital Kaken ID
Makino, Hirofumi Okayama University ORCID Kaken ID publons researchmap
the Diabetic Nephropathy Remission and Regression Team Trial in Japan (DNETT‐Japan) collaborative group
Abstract
Aims/Introduction
We evaluated the efficacy of multifactorial intensive treatment (IT) on renal outcomes in patients with type 2 diabetes and advanced‐stage diabetic kidney disease (DKD).
Materials and Methods
The Diabetic Nephropathy Remission and Regression Team Trial in Japan (DNETT‐Japan) is a multicenter, open‐label, randomized controlled trial with a 5‐year follow‐up period. We randomly assigned 164 patients with advanced‐stage diabetic kidney disease (urinary albumin‐to‐creatinine ratio ≥300 mg/g creatinine, serum creatinine level 1.2–2.5 mg/dL in men and 1.0–2.5 mg/dL in women) to receive either IT or conventional treatment. The primary composite outcome was end‐stage kidney failure, doubling of serum creatinine or death from any cause, which was assessed in the intention‐to‐treat population.
Results
The IT tended to reduce the risk of primary end‐points as compared with conventional treatment, but the difference between treatment groups did not reach the statistically significant level (hazard ratio 0.69, 95% confidence interval 0.43–1.11; P = 0.13). Meanwhile, the decrease in serum low‐density lipoprotein cholesterol level and the use of statin were significantly associated with the decrease in primary outcome (hazard ratio 1.14; 95% confidence interval 1.05–1.23, P < 0.001 and hazard ratio 0.53, 95% confidence interval 0.28–0.998, P < 0.05, respectively). The incidence of adverse events was not different between treatment groups.
Conclusions
The risk of kidney events tended to decrease by IT, although it was not statistically significant. Lipid control using statin was associated with a lower risk of adverse kidney events. Further follow‐up study might show the effect of IT in patients with advanced diabetic kidney disease.
Keywords
Diabetic kidney disease
Diabetic nephropathy
Diabetic Nephropathy Remission and Regression Team Trial in Japan
Published Date
2020-08-08
Publication Title
Journal of Diabetes Investigation
Volume
volume12
Issue
issue2
Publisher
Wiley
Start Page
207
End Page
216
ISSN
2040-1116
NCID
AA12488319
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
Copyright Holders
© 2020 The Authors
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NAID
DOI
Web of Science KeyUT
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isVersionOf https://doi.org/10.1111/jdi.13339
License
https://creativecommons.org/licenses/by-nc/4.0/