ID | 60377 |
フルテキストURL | |
著者 |
Shikata, Kenichi
Center for Innovative Clinical Medicine, Okayama University Hospital
ORCID
Kaken ID
publons
researchmap
Haneda, Masakazu
Division of Metabolism and Biosystemic Science, Department of Medicine, Asahikawa Medical University
Ninomiya, Toshiharu
Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
Koya, Daisuke
Department of Diabetology & Endocrinology, Kanazawa Medical University
Suzuki, Yoshiki
Health Administration Center, Niigata University
Suzuki, Daisuke
Suzuki Diabetes Clinic
Ishida, Hitoshi
Research Center for Health Care, Nagahama City Hospital
Akai, Hiroaki
Division of Metabolism and Diabetes, Tohoku Medical and Pharmaceutical University
Tomino, Yasuhiko
Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine
Uzu, Takashi
Division of Nephrology, Department of Medicine, Nippon Life Hospital
Nishimura, Motonobu
Department of Diabetes and Endocrinology, National Hospital Organization Chiba‐East National Hospital
Maeda, Shiro
Department of Advanced Genomic and Laboratory Medicine, Graduate School of Medicine, University of the Ryukyus
Ogawa, Daisuke
Okayama Diabetes and Neurology Clinic
Miyamoto, Satoshi
Center for Innovative Clinical Medicine, Okayama University Hospital
Kaken ID
the Diabetic Nephropathy Remission and Regression Team Trial in Japan (DNETT‐Japan) collaborative group
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抄録 | Aims/Introduction
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).
Materials and Methods
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.
Results
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.
Conclusions
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.
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キーワード | Diabetic kidney disease
Diabetic nephropathy
Diabetic Nephropathy Remission and Regression Team Trial in Japan
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発行日 | 2020-08-08
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出版物タイトル |
Journal of Diabetes Investigation
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巻 | 12巻
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号 | 2号
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出版者 | Wiley
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開始ページ | 207
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終了ページ | 216
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ISSN | 2040-1116
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NCID | AA12488319
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資料タイプ |
学術雑誌論文
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言語 |
英語
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OAI-PMH Set |
岡山大学
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著作権者 | © 2020 The Authors
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論文のバージョン | publisher
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Web of Science KeyUT | |
関連URL | isVersionOf https://doi.org/10.1111/jdi.13339
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ライセンス | https://creativecommons.org/licenses/by-nc/4.0/
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