Abstract: TH-OR048
Associations Between Antidiabetes Medications and Mortality in Patients on Dialysis: A National Study from Taiwan
Session Information
- Hemodialysis: Novel Interventions
November 06, 2025 | Location: Room 351D, Convention Center
Abstract Time: 04:50 PM - 05:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Pan, Szu-Yu, National Taiwan University Hospital, Taipei City, Taiwan
- Teng, Naichi, National Health Research Institutes, Zhunan Township, Taiwan
- Chen, Likwang, National Health Research Institutes, Zhunan Township, Taiwan
Background
A significant proportion of dialysis patients require antidiabetic medications for glycemic control. However, the associations between different antidiabetic medications and mortality remain unclear.
Methods
We used the Taiwan National Health Insurance Research Database to identify incident dialysis patients. The monthly dispensing of eight different classes of antidiabetic medications, including insulin, dipeptidyl peptidase-4 inhibitor (DDP-4i), meglitinide, sulfonylurea, alpha-glucosidase inhibitor (AGI), thiazolidinedione, biguanide, glucagon-like peptide-1 receptor agonist (GLP-1 RA), was recorded. A medication possession ratio (MPR) equal to or greater than 0.3 was used to define medication use. Cox proportional hazards models were constructed to examine the associations between medication use and mortality. Associations with hypoglycemia necessitating emergency department visits or hospitalization were also analyzed.
Results
A total of 46,149 diabetic patients who initiated dialysis between Jan 1, 2011, and Dec 31, 2019, were selected for analysis. Forty-four percent of patients used only one class of antidiabetic medications, followed by 30% who used two classes. Among patients on monotherapy, most used insulin (52%), DDP-4i (23%), meglitinide (15%), and sulfonylurea (8.5%). Only a total of 1.5% of patients were monotherapy users of AGI (0.9%), thiazolidinedione (0.3%), biguanide (0.2%), and GLP-1 RA (0.1%). Compared with monotherapy users of insulin, monotherapy users of DDP-4i were associated with lower risks of both mortality and hypoglycemia in multivariable Cox models. In addition, longer exposure to DDP-4i (as represented by a higher MPR) was associated with a lower risk of mortality (Figure 1).
Conclusion
DDP-4i use may be associated with a lower risk of mortality and hypoglycemia than other antidiabetic medications in dialysis patients.
Figure 1. The associations between different antidiabetic medications and mortality in monotherapy users.
Funding
- Government Support – Non-U.S.