{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:27:21Z","timestamp":1790234841397,"version":"4.1.0"},"reference-count":29,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:00:00Z","timestamp":1717027200000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020869","name":"AstraZeneca KK","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100020869","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["19ek0210095h0003"],"award-info":[{"award-number":["19ek0210095h0003"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["20ek0210135h0001"],"award-info":[{"award-number":["20ek0210135h0001"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["20km0405210h0003"],"award-info":[{"award-number":["20km0405210h0003"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["23ek0109571h0003"],"award-info":[{"award-number":["23ek0109571h0003"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["19AC1002"],"award-info":[{"award-number":["19AC1002"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2024,5,16]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>We compared the kidney outcomes between patients with diabetic kidney disease (DKD) aged \u226575 years initiating sodium-glucose cotransporter 2 (SGLT2) inhibitors versus other glucose-lowering drugs, additionally presenting with or without proteinuria.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research design and methods<\/jats:title>\n                  <jats:p>Using the Japan Chronic Kidney Disease Database, we developed propensity scores, implementing a 1:1 matching protocol. The primary outcome included the decline rate in estimated glomerular filtration rate (eGFR), and secondary outcomes incorporated a composite of a 40% reduction in eGFR or progression to end-stage kidney disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At baseline, the mean age at initiation of SGLT2 inhibitors (n=348) or other glucose-lowering medications (n=348) was 77.7 years. The mean eGFR was 59.3\u2009mL\/min\/1.73m<jats:sup>2<\/jats:sup> and proteinuria was 230 (33.0%) patients. Throughout the follow-up period, the mean annual rate of eGFR change was \u22120.80\u2009mL\/min\/1.73 m<jats:sup>2<\/jats:sup>\/year (95%\u2009CI \u22121.05 to \u22120.54) among SGLT2 inhibitors group and \u22121.78\u2009mL\/min\/1.73 m<jats:sup>2<\/jats:sup>\/year (95%\u2009CI \u22122.08 to \u22121.49) in other glucose-lowering drugs group (difference in the rate of eGFR decline between the groups was 0.99\u2009mL\/min\/1.73 m<jats:sup>2<\/jats:sup>\/year (95%\u2009CI 0.5 to 1.38)), favoring SGLT2 inhibitors (p&lt;0.001). Composite renal outcomes were observed 38 in the SGLT2 inhibitors group and 57 in the other glucose-lowering medications group (HR 0.64, 95%\u2009CI 0.42 to 0.97). There was no evidence of an interaction between SGLT2 inhibitors initiation and proteinuria.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The benefits of SGLT2 inhibitors on renal outcomes are also applicable to older patients with DKD aged\u226575 years.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjdrc-2024-004115","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T18:49:02Z","timestamp":1717094942000},"page":"e004115","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Kidney outcomes of SGLT2 inhibitors among older patients with diabetic kidney disease in real-world clinical practice: the Japan Chronic Kidney Disease Database Ex"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8214-5251","authenticated-orcid":false,"given":"Kaori","family":"Kitaoka","sequence":"first","affiliation":[{"name":"Noncommunicable Disease (NCD) Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Yano","sequence":"additional","affiliation":[{"name":"Noncommunicable Disease (NCD) Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan"},{"name":"Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Nagasu","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Kanegae","sequence":"additional","affiliation":[{"name":"Office of Research and Analysis, Genki Plaza Medical Center for Health Care, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriharu","family":"Chishima","sequence":"additional","affiliation":[{"name":"Cardiovascular, Renal and Metabolism, BioPharmaceuticals Medical, AstraZeneca, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Akiyama","sequence":"additional","affiliation":[{"name":"Cardiovascular, Renal and Metabolism, BioPharmaceuticals Medical, AstraZeneca, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kouichi","family":"Tamura","sequence":"additional","affiliation":[{"name":"Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Kashihara","sequence":"additional","affiliation":[{"name":"Kawasaki Geriatric Medical Center, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,5,30]]},"reference":[{"key":"2025073112054342000_12.3.e004115.1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2007040422"},{"key":"2025073112054342000_12.3.e004115.2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.1.195"},{"key":"2025073112054342000_12.3.e004115.3","doi-asserted-by":"crossref","DOI":"10.1186\/s12877-018-0732-4","article-title":"Diabetic kidney disease in the elderly: prevalence and clinical correlates","volume":"18","author":"Russo","year":"2018","journal-title":"BMC Geriatr"},{"key":"2025073112054342000_12.3.e004115.4","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2022.871272","article-title":"Comparison of nonalbuminuric and albuminuric diabetic 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