title: Exenatide and sitagliptin are not associated with increased risk of acute renal failure: a retrospective claims analysis.
abstract: OBJECTIVE
  This study evaluated whether the risk of acute renal failure (ARF) increases with exenatide and sitagliptin use.
  
  
  METHODS
  A retrospective cohort study of a large medical and pharmacy claims database was performed. Data for 4 91 539 patients were analysed. Cox proportional hazard models were used to compare the risk of ARF between diabetic and non-diabetic subjects and between diabetic patients treated with exenatide, sitagliptin and control medications.
  
  
  RESULTS
  Adjusted Cox analyses showed diabetic subjects had a higher risk of ARF [HR 1.51, confidence interval (CI) 1.26-1.81, p < 0.001] than non-diabetic controls. Compared with diabetic controls, neither exenatide (HR 0.77, CI 0.42-1.41, p = 0.40) nor sitagliptin (HR 1.17, CI 0.82-1.65, p = 0.39) increased the risk of ARF.
  
  
  CONCLUSIONS
  Our study revealed an increased incidence of ARF in diabetic versus non-diabetic patients but no association between use of exenatide or sitagliptin and ARF. Because of the limitations of this observational analysis, we cannot exclude the possibility of a very small increased risk.
authors.affiliation: Clinical Innovations, Medco Health Solutions, Franklin Lakes, New Jersey, USA. merri_pendergrass@medco.com
authors.forename: M
authors.initials: M
authors.lastname: Pendergrass
authors.forename: C
authors.initials: C
authors.lastname: Fenton
authors.forename: S M
authors.initials: SM
authors.lastname: Haffner
authors.forename: W
authors.initials: W
authors.lastname: Chen
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000209:etiology / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D004348:Drug Labeling; D000077270:Exenatide; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D016016:Proportional Hazards Models; D011719:Pyrazines / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D012189:Retrospective Studies; D018570:Risk Assessment; D000068900:Sitagliptin Phosphate; D014230:Triazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D014688:Venoms / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D010455:Peptides; D011719:Pyrazines; D014230:Triazoles; D014688:Venoms; D000077270:Exenatide; D000068900:Sitagliptin Phosphate