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
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