Randomized trial of an intensified, multifactorial intervention in patients with advanced-stage diabetic kidney disease: Diabetic Nephropathy Remission and Regression Team Trial in Japan (DNETT-Japan).
Diabetic Nephropathy Remission and Regression Team Trial in Japan
Diabetic kidney disease
Diabetic nephropathy
Journal
Journal of diabetes investigation
ISSN: 2040-1124
Titre abrégé: J Diabetes Investig
Pays: Japan
ID NLM: 101520702
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
17
02
2020
revised:
13
06
2020
accepted:
23
06
2020
pubmed:
1
7
2020
medline:
12
10
2021
entrez:
30
6
2020
Statut:
ppublish
Résumé
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). 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. 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. 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.
Identifiants
pubmed: 32597548
doi: 10.1111/jdi.13339
pmc: PMC7858124
doi:
Substances chimiques
Biomarkers
0
Blood Glucose
0
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
207-216Subventions
Organisme : Ministry of Health, Labor and Welfare of Japan
ID : 200624010B
Organisme : Okayama Medical Foundation
Organisme : Asahi Kasei Pharma
Organisme : Astellas
Organisme : AstraZeneca
Organisme : Otsuka
Organisme : Kowa Pharmaceutical
Organisme : Daiichi Sankyo
Organisme : Sanwa Kagaku
Organisme : Sanofi Aventis
Organisme : Sumitomo Dainippon Pharma
Organisme : Takeda
Organisme : Mitsubishi Tanabe Pharma
Organisme : Chugai
Organisme : Terumo
Organisme : Eli Lilly
Organisme : Novartis Pharma
Organisme : MSD
Organisme : Bayer
Organisme : Boehringer Ingelheim
Organisme : Eizai
Organisme : Teijin Pharma
Informations de copyright
© 2020 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
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