BackgroundWe investigated the association between post‐hospital discharge use of sodium glucose cotransporter‐2 inhibitors (SGLT‐2is) compared to dipeptidyl peptidase‐4 inhibitors (DPP‐4is) and the incidence of hospitalization for acute renal failure (ARF) and chronic kidney disease (CKD) in people with type 2 diabetes.MethodsWe conducted a retrospective cohort study using linked hospital and prescription data. Our cohort included people aged ≥30 years with type 2 diabetes discharged from a hospital in Victoria, Australia, from December 2013 to June 2018. We compared new users of SGLT‐2is with new users of DPP‐4is following discharge. People were followed from first dispensing of a SGLT‐2i or DPP‐4i to a subsequent hospital admission for ARF or CKD. We used competing risk models with inverse probability of treatment weighting (IPTW) to estimate subhazard ratios.ResultsIn total, 9620 people initiated SGLT‐2is and 9962 initiated DPP‐4is. The incidence rate of ARF was 12.3 per 1000 person‐years (median years of follow‐up [interquartile range [IQR] 1.4 [0.7–2.2]) among SGLT‐2i initiators and 18.9 per 1000 person‐years (median years of follow‐up [IQR] 1.7 [0.8–2.6]) among DPP‐4i initiators (adjusted subhazard ratio with IPTW 0.78; 95% confidence interval [CI] 0.70–0.86). The incidence rate of CKD was 6.0 per 1000 person‐years (median years of follow‐up [IQR] 1.4 [0.7–2.2]) among SGLT‐2i initiators and 8.9 per 1000 person‐years (median years of follow‐up [IQR] 1.7 [0.8–2.6]) among DPP‐4i initiators (adjusted subhazard ratio with IPTW 0.83; 95% CI 0.73–0.94).ConclusionsReal‐world data support using SGLT‐2is over DPP‐4is for preventing acute and chronic renal events in people with type 2 diabetes.image

中文翻译：

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钠葡萄糖协同转运蛋白 2 抑制剂与二肽基肽酶 4 抑制剂与 2 型糖尿病出院患者肾脏结局之间的关联：一项基于人群的队列研究

背景我们研究了出院后使用钠-葡萄糖协同转运蛋白-2抑制剂（SGLT-2is）与二肽基肽酶-4抑制剂（DPP-4is）相比与急性肾衰竭（ARF）和慢性肾脏病住院发生率之间的关系2 型糖尿病患者（CKD）。方法我们使用关联的医院和处方数据进行了一项回顾性队列研究。我们的队列包括 2013 年 12 月至 2018 年 6 月从澳大利亚维多利亚州一家医院出院的年龄≥30 岁的 2 型糖尿病患者。我们对出院后 SGLT-2is 的新用户与 DPP-4is 的新用户进行了比较。从首次配药 SGLT-2i 或 DPP-4i 到随后因 ARF 或 CKD 入院，对患者进行随访。我们使用具有治疗权重逆概率 (IPTW) 的竞争风险模型来估计亚危险比率。结果总共有 9620 人启动了 SGLT-2is，9962 人启动了 DPP-4is。 SGLT-2i 启动者中 ARF 的发生率为每 1000 人年 12.3 例（中位随访年数 [四分位数间距 [IQR] 1.4 [0.7-2.2]），每 1000 人年 18.9 例（中位随访年数）。 DPP-4i 引发剂中的 [IQR] 1.7 [0.8–2.6]）（调整后的亚危害比为 IPTW 0.78；95% 置信区间 [CI] 0.70–0.86）。 SGLT-2i 启动者中 CKD 的发病率为每 1000 人年 6.0 人（中位随访年数 [IQR] 1.4 [0.7-2.2]），每 1000 人年 CKD 的发病率为 8.9 人（中位随访年数 [IQR]1.4 [IQR]）。 ] 1.7 [0.8–2.6]）在 DPP-4i 启动者中（调整后的亚危险比为 IPTW 0.83；95% CI 0.73–0.94）。结论使用 SGLT-2is 相对于 DPP-4is 的真实世界数据支持预防急性和慢性肾脏事件患有 2 型糖尿病的人。图像