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)
Autor: | Kenichi Shikata, Masakazu Haneda, Toshiharu Ninomiya, Daisuke Koya, Yoshiki Suzuki, Daisuke Suzuki, Hitoshi Ishida, Hiroaki Akai, Yasuhiko Tomino, Takashi Uzu, Motonobu Nishimura, Shiro Maeda, Daisuke Ogawa, Satoshi Miyamoto, Hirofumi Makino, the Diabetic Nephropathy Remission and Regression Team Trial in Japan (DNETT‐Japan) collaborative group |
---|---|
Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Blood Glucose
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism Population Type 2 diabetes Diabetic nephropathy 030204 cardiovascular system & hematology Lower risk Diseases of the endocrine glands. Clinical endocrinology law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Randomized controlled trial law Diabetes mellitus Internal medicine Early Medical Intervention Internal Medicine Medicine Humans Diabetic Nephropathies 030212 general & internal medicine Prospective Studies Diabetic kidney disease education Creatinine education.field_of_study business.industry Hazard ratio Remission Induction General Medicine Articles Middle Aged medicine.disease RC648-665 Prognosis Clinical Trial Diabetic Nephropathy Remission and Regression Team Trial in Japan Clinical Science and Care chemistry Diabetes Mellitus Type 2 Female business Biomarkers Follow-Up Studies |
Zdroj: | Journal of Diabetes Investigation Journal of Diabetes Investigation, Vol 12, Iss 2, Pp 207-216 (2021) |
ISSN: | 2040-1124 2040-1116 |
Popis: | 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 The Diabetic Nephropathy Remission and Regression Team Trial in Japan was designed to clarify the beneficial effects of multifactorial intensified intervention by the team approach with medical staffs at each institution. There was an overall trend toward a lower risk on the development of kidney events in the intensive treatment group than in the conventional treatment group in this trial, but the benefit of intensive treatment could not be confirmed statistically. Lipid control by statin was associated with lower risk of kidney events in addition to strict control of blood glucose and blood pressure. |
Databáze: | OpenAIRE |
Externí odkaz: |