Thiazolidinedione use is associated with better survival in hemodialysis patients with non-insulin dependent diabetes.
Thiazolidinedione use is associated with better survival in hemodialysis patients with non-insulin dependent diabetes.
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DOI：
10.1038/ki.2009.4
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发表时间：
2009-05
影响因子：
19.6
通讯作者：
Feldman, Harold I.
中科院分区：
文献类型：
--
作者：
Brunelli, Steven M.;Thadhani, Ravi;Ikizler, T. Alp;Feldman, Harold I.
糖尿病透析患者的心血管死亡率特别高，蛋白质能量浪费导致的发病率也很高。鉴于噻唑烷二酮治疗可以降低这两个因素，我们在全国5290例糖尿病透析患者队列中研究了使用噻唑烷二酮对慢性透析患者存活率的影响。根据处方数据对噻唑烷二酮的使用进行评估，并根据观察到的相互作用对胰岛素的使用进行分层分析。在初步分析中，在不需要胰岛素但不需要胰岛素的受试者中，噻唑烷二酮治疗与显著降低全因死亡率有关，调整后的风险比分别为0.53(0.31-0.89)和0.82(0.46-1.47)。敏感性分析发现，根据适应症、糖尿病的严重性、潜在的反向因果关系和时间变化的暴露模式的混淆，这些发现是可靠的。在这些研究得到证实后，将需要研究全因死亡率下降的机制。
Cardiovascular mortality is especially high among dialysis patients with diabetes, as is morbidity due to protein energy wasting. Given that both of these factors may be decreased by thiazolidinedione treatment, we studied the effect of thiazolidinedione use on survival among chronic dialysis patients in a national cohort of 5290 incident dialysis patients with diabetes. Thiazolidinedione use was assessed according to prescription data, and the analyses were stratified based on insulin use due to observed interaction. In the primary analysis, thiazolidinedione treatment was associated with significantly lower all-cause mortality among insulin-free but not insulin-requiring subjects, with adjusted hazards ratios of 0.53 (0.31–0.89) and 0.82 (0.46–1.47) respectively. Sensitivity analyses found the findings to be robust with respect to confounding by indication, severity of the diabetes, potential reverse causality, and time varying exposure patterns. The mechanism of this decline in all-cause mortality will need to be examined after these studies are confirmed.
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影响因子：
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