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Chronic Kidney Disease Progression Risk in Patients With Diabetes Mellitus Using Dihydropyridine Calcium Channel Blockers: A Nationwide, Population-Based, Propensity Score Matching Cohort Study

Background: Whether diabetes mellitus (DM) patients with chronic kidney disease (CKD) can glean individual renal benefit from dihydropyridine calcium channel blockers (DCCBs) remains to be determined. We conducted a nationwide, population-based, propensity score matching cohort study to examine the...

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Main Authors: Shih-Yi Lin (Author), Cheng-Li Lin (Author), Cheng-Chieh Lin (Author), Wu-Huei Hsu (Author), Chung-Y. Hsu (Author), Chia-Hung Kao (Author)
Format: Book
Published: Frontiers Media S.A., 2022-03-01T00:00:00Z.
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Summary:Background: Whether diabetes mellitus (DM) patients with chronic kidney disease (CKD) can glean individual renal benefit from dihydropyridine calcium channel blockers (DCCBs) remains to be determined. We conducted a nationwide, population-based, propensity score matching cohort study to examine the effect of DCCBs on CKD progression in DM patients with CKD.Methods: One million individuals were randomly sampled from Taiwan's National Health Insurance Research Database. The study cohort consisted of DM patients with CKD who used DCCBs. The comparison cohort was propensity-matched for demographic characteristics and comorbidities. The endpoint was advanced CKD or end-stage renal disease (ESRD). The Cox proportional hazards model was used to calculate the risks.Results: In total, 9,761 DCCB users were compared with DCCB nonusers at a ratio of 1:1. DCCB users had lower risk of advanced CKD and ESRD than nonusers-with adjusted hazard ratio [aHR; 95% confidence interval (CI)] of 0.64 (0.53-0.78) and 0.59 (95% CI, 0.50-0.71) for advanced CKD and ESRD, respectively. DCCB users aged ≥65 years had the lowest incidence rates of advanced CKD and ESRD-with aHR (95% CI) of 0.47 (0.34-0.65) and 0.48 (0.35-0.65) for advanced CKD and ESRD, respectively. Finally, cumulative DCCB use for >1,100 days was associated with the lowest advanced CKD and ESRD risks [(aHR, 0.29 (95% CI, 0.19-0.44)].Conclusion: DM patients with CKD who used DCCBs had lower risk of progression to advanced CKD and ESRD than nonusers did.
Item Description:1663-9812
10.3389/fphar.2022.786203

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