Document Detail


Thiazolidinedione use is associated with better survival in hemodialysis patients with non-insulin dependent diabetes.
MedLine Citation:
PMID:  19190679     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiovascular mortality is especially high among dialysis patients with diabetes, as is morbidity due to protein energy wasting. Given that both of these factors may be decreased by thiazolidinedione treatment, we studied the effect of thiazolidinedione use on survival among chronic dialysis patients in a national cohort of 5290 incident dialysis patients with diabetes. Thiazolidinedione use was assessed according to prescription data, and the analyses were stratified based on insulin use due to observed interaction. In the primary analysis, thiazolidinedione treatment was associated with significantly lower all-cause mortality among insulin-free but not insulin-requiring subjects, with adjusted hazards ratios of 0.53 (0.31-0.89) and 0.82 (0.46-1.47) respectively. Sensitivity analyses found the findings to be robust with respect to confounding by indication, severity of the diabetes, potential reverse causality, and time varying exposure patterns. The mechanism of this decline in all-cause mortality will need to be examined after these studies are confirmed.
Authors:
Steven M Brunelli; Ravi Thadhani; T Alp Ikizler; Harold I Feldman
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-02-04
Journal Detail:
Title:  Kidney international     Volume:  75     ISSN:  1523-1755     ISO Abbreviation:  Kidney Int.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-15     Completed Date:  2009-07-07     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  961-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Cohort Studies
Diabetes Mellitus, Type 1 / complications,  drug therapy,  mortality
Diabetes Mellitus, Type 2 / complications*,  drug therapy*,  mortality
Humans
Kidney Failure, Chronic / mortality,  therapy*
Renal Dialysis
Retrospective Studies
Survival Rate
Thiazolidinediones / therapeutic use*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
1K23DK079056/DK/NIDDK NIH HHS; K23 DK079056/DK/NIDDK NIH HHS; K23 DK079056-01A1/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Thiazolidinediones
Comments/Corrections

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