OBJECTIVES

: Both diabetes and chronic kidney disease (CKD) are a burden to health spendings. People with diabetes have CKD that progresses about twice as fast. In order to delay renal replacement as much as possible, two long-term conditions should be treated simultaneously.

The objective of the study is to determine the impact of preventive antidiabetic treatments on the prevention of renal function.

METHODS

: The analysis was based on the French ND-CRIS cohort. The main outcome is the evolution of GFR, which allows to know the efficiency of a treatment on the degradation of the renal function.

Three comparison groups were identified : (1) no antidiabetic treatment vs. oral antidiabetic treatment only; (2) no antidiabetic treatment vs. insulin antidiabetic treatment only; (3) no antidiabetic treatment vs. oral and insulin antidiabetic treatment.

After setting up a propensity score to make the groups comparable, the preventive effect of antidiabetic treatments was estimated by two consecutive linear regressions.

RESULTS

: Of the initial 1589 patients, we selected 903 patients with at least 2 GFR measurements available. The mean age of the patients was 73 years. The mean GFR was 32.47 ml/min/1.73m², corresponding to advanced CKD. All patients had type 2 diabetes. Of the 903 patients selected, 13% had no antidiabetic treatment, 36% had oral antidiabetic treatment, 30% had insulin-only antidiabetic treatment and 21% had oral and insulin treatment.

Over the entire follow-up period, 96 patients progressed to end-stage renal failure.

On average, patients show a loss of GFR of 7.5% between two visits. However, no significant difference was shown between the antidiabetic treatments on the preventive effect on renal function.

CONCLUSIONS

: As the analyses showed no significant results on the clinical differences of the antidiabetic treatments, all treatments work to protect renal function.