Kidney Week

Abstract: SA-PO168

Prevalence of Increased Rate of Reduced Estimated Glomerular Filtration despite Advances in Diabetes Mellitus Treatment

Session Information

• Diabetic Kidney Disease: Clinical - II
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 602 Diabetic Kidney Disease: Clinical

Author

• Araki, Makoto, Suwa Central Hospital, Chino, Nagano, Japan

Makoto Araki,

Background

Unlike in other countries, diabetes treatment in Japan follows a unique approach, such as the rare use of metformin before 2010 and the frequent use of dipeptidyl peptidase-4 inhibitor (DPP4i) after 2009. We investigated the pharmacological effects of antidiabetic drugs on glycemic control and renal function in Japan.

Methods

We conducted a retrospective, serial, cross-sectional analysis of individuals aged ≥18 years who used more than one antidiabetic drug at a single center in Japan between 2008 and 2017. The exclusion criteria were individuals who had continuously sustained an estimated glomerular filtration rate (eGFR) of <10 ml/min/1.73 m² (including those who received chronic dialysis). All data were extracted from patient’s medical records.

Results

Between 2008 and 2017, the number of patients with diabetes mellitus has increased from 805 to 1190, and the average age of diabetic patients has increased from 65.6 to 68.8 years. Meanwhile, the number of prescription drugs has increased by 2.3 times. The use of antidiabetic drugs has remarkably increased the DPP4I and metformin levels (0% to 34% and 24%, respectively), whereas the insulin (46% to 15%) and sulfonylurea (42% to 11%) levels have decreased. The hemoglobin A1c levels have improved (7.8% to 7.3%); however, eGFR has decreased (from 73 to 65 ml/min/1.73 m²), and the ratio of eGFR <60 ml/min/1.73 m² group has increased (from 25% to 39%). This tendency remained unchanged even when analyzed for background-matched cases between 2008 and 2017.

Conclusion

Pharmacological advances in the treatment of diabetes mellitus can improve glycemic control but not renal function.