Kidney Week

Abstract: TH-PO1164

Oral Biguanide Use Is Associated with Lower Incidence of AKI and Mortality in COVID-19 Patients: A Nationwide Study Using the Diagnosis Procedure Combination System in Japan

Session Information

• COVID-19
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

• 000 Coronavirus (COVID-19)

Authors

• Sugimoto, Mari, Tokyo Ika Shika Daigaku Daigakin Ishigaku Sogo Kenkyuka, Bunkyo-ku, Tokyo, Japan

Mari Sugimoto, PhD

• Kikuchi, Hiroaki, Tokyo Ika Shika Daigaku Daigakin Ishigaku Sogo Kenkyuka, Bunkyo-ku, Tokyo, Japan

Hiroaki Kikuchi, MD, PhD

• Hirakawa, Akihiro, Tokyo Ika Shika Daigaku Daigakin Ishigaku Sogo Kenkyuka, Bunkyo-ku, Tokyo, Japan

Akihiro Hirakawa, PhD

• Mikami, Risako, Tokyo Ika Shika Daigaku Daigakin Ishigaku Sogo Kenkyuka, Bunkyo-ku, Tokyo, Japan

Risako Mikami, PhD

• Mizutani, Koji, Tokyo Ika Shika Daigaku Daigakin Ishigaku Sogo Kenkyuka, Bunkyo-ku, Tokyo, Japan

Koji Mizutani

• Sohara, Eisei, Tokyo Ika Shika Daigaku Daigakin Ishigaku Sogo Kenkyuka, Bunkyo-ku, Tokyo, Japan

Eisei Sohara, MD, PhD

• Uchida, Shinichi, Tokyo Ika Shika Daigaku Daigakin Ishigaku Sogo Kenkyuka, Bunkyo-ku, Tokyo, Japan

Shinichi Uchida, MD, PhD

Group or Team Name

• Translational Systems Biology Center.

Background

Recent studies have reported renoprotective effects of biguanides (BG), but their effectiveness in COVID-19 patients remains unclear.

Methods

From the 2021 and 2022 DPC inpatient databases, which cover the era following the development of COVID-19 vaccines, we extracted data on 106,161 COVID-19 patients aged 20 to under 70 years who also had diabetes treated with oral antidiabetic agents including biguanides, dipeptidyl peptidase-4 inhibitors (DPP-4), sodium-glucose cotransporter type 2 inhibitors (SGLT2), sulfonylureas (SU), alpha-glucosidase inhibitors (aGI), glucagon-like peptide-1 (GLP-1) analogs, thiazolidinediones (TZD).
Using propensity score matching, based on variables such as age, sex, BMI, and chronic kidney disease stage, we compared two groups: those taking BG medications (n = 7997) and those not taking BG medications (non-BG group, n = 7997). The primary outcome was in-hospital mortality, and the secondary outcome was the incidence of acute kidney injury (AKI) during hospitalization. Logistic regression analysis and Cox proportional hazards models were used for analysis.

Results

The incidence of in-hospital mortality was significantly lower in the BG group (0.7%) compared to the non-BG group (1.2%) (p = 0.002). Similarly, the incidence of AKI during hospitalization was significantly lower in the BG group (0.7%) compared to the non-BG group (1.1%) (p = 0.025). Kaplan-Meier analysis showed a significantly better survival rate in the BG group (hazard ratio 0.675, 95% confidence interval 0.484-0.941, p < 0.0001).

Conclusion

In COVID-19 patients, oral biguanide use may be associated with a reduced risk of AKI and in-hospital mortality.

Kaplan–Meier estimates of all-cause mortality for COVID 19 patients with DM stratified by biguanide medication usage