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. 2016 Jan 11:6:18996.
doi: 10.1038/srep18996.

Risk of liver injury after α-glucosidase inhibitor therapy in advanced chronic kidney disease patients

Chih-Chin Kao  1   2 , Pei-Chen Wu  3 , Che-Hsiung Wu  4 , Li-kwang Chen  5 , Hsi-Hsien Chen  1   6 , Mai-Szu Wu  1   6 , Vin-Cent Wu  7   8
Affiliations

Risk of liver injury after α-glucosidase inhibitor therapy in advanced chronic kidney disease patients

Chih-Chin Kao et al. Sci Rep. .

Abstract

Although α-glucosidase inhibitors (AGIs) are commonly used for controlling postprandial blood glucose, AGIs-induced liver injuries have been reported. However, the relationship between AGIs and liver injuries in advanced chronic kidney disease (CKD) patients remains unexplored. In this nationwide case-control study, we recruited 1765 advanced diabetic CKD patients, who received AGIs therapy from January 1, 2000 to December 31, 2010 as the study sample and 5295 matched controls. Recent and former AGIs users were defined as patients who received the AGIs prescription for 30-60 d and 30-210 d before the event of liver injury. The risk of AGIs-induced liver injury was examined using time-dependent Cox proportional hazards model. Liver injury occurred in 3.9% of patients in the study group and 3.3% of patients in the control group. AGIs use did not increase the risk of liver injury in advanced CKD patients (P = 0.19). The stratified analysis indicated no increased risk of liver injury in all AGIs-using subgroups (all P > 0.05). The available evidence supports extending the use of AGIs without increasing the risk of liver injury in patients with advanced CKD. Additional randomized controlled trials are warranted to confirm our results.

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Figures

Figure 1
Figure 1. The mean DDD and risk of liver injury.
The function curve with values of the logs of odds ratios from the GAM with splines regarding AGIs use for multilevel discrete-time event history analysis of the risk of liver injury among advanced chronic kidney disease patients of our study. The curve was centered to have an average of zero over the range of the data. The dashed lines indicated approximated point-wise 95% CIs. (Abbreviations: CI, confidence interval; DDD, defined daily dose; GAM, generalized additive model).
Figure 2
Figure 2. Multivariate stratified analysis indicated no increased risk of liver injury in all α-glucosidase inhibitor (AGIs)-using subgroups.
Figure 3
Figure 3. Flow chart presenting the study subjects.
See this image and copyright information in PMC

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