Oral Antihyperglycemic Agents and Renal Disease

Yale, Jean‐François

doi:10.1681/asn.2004110974

Cited by 75 publications

(55 citation statements)

References 21 publications

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“…Therapeutic alternatives in patients with type 2 diabetes and ERSD are limited because of reduced glomerular filtration rate (GFR) is accompanied by accumulation of some drugs and/or their metabolites (10). PPARg agonists are a new group of oral antidiabetic agents recently introduced in the therapy of type 2 diabetes (6,11).…”

Section: Introductionmentioning

confidence: 99%

Peroxisome proliferator-activated receptor gamma agonists in renal disease

Iglesias

Díez

2006

eur j endocrinol

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Type 2 diabetes is a well recognised cause of chronic renal failure (CRF). Only few oral antidiabetic drugs can be used for treating type 2 diabetes in patients with CRF. Among them are repaglinide, a rapid-acting prandial insulin releaser, and peroxisome proliferator-activated receptor gamma (PPARg) agonists, such as rosiglitazone and pioglitazone. These compounds are metabolised in the liver, therefore accumulation of the drug and the risk of severe and prolonged hypoglycaemia are minimised. PPARg receptors are expressed in many tissues including the kidney. Recently, numerous healthful effects of PPARg agonists on several aspects related to renal function have been increasingly reported. These drugs have shown to possess many advantageous anti-inflammatory, haemodynamic, vascular and metabolic effects. In the present paper we have reviewed the more recent experimental studies that evaluated these potential beneficial effects of PPARg agonists on renal function and revised the results of their utilisation in patients with different degrees of renal impairment, in dialysis patients, and in patients with diabetes mellitus after kidney transplantation. Finally, tolerability and safety profile of PPARg agonists in patients with reduced glomerular filtration rate are also analysed. European Journal of Endocrinology 154 613-621

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Section: Introductionmentioning

confidence: 99%

Peroxisome proliferator-activated receptor gamma agonists in renal disease

Iglesias

Díez

2006

eur j endocrinol

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“…mic agents, such as sulfonylurea (SU), are not suitable due to the risk of prolonged hypoglycemia, while metformin is contraindicated due to the risk of lactic acidosis in patients with ESRD [1,2]. Therefore, insulin injection therapy remains the mainstay of treatment in diabetic patients receiving hemodialysis (HD) therapy in order to achieve good glycemic control.…”

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confidence: 99%

The dipeptidyl peptidase-4 (DPP-4) inhibitor vildagliptin improves glycemic control in type 2 diabetic patients undergoing hemodialysis

et al. 2011

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Numerous drugs with different mechanisms of action are currently in use with the aim of improving glycemic control, and drugs with different pharmacologic profiles are employed in the management of type 2 diabetes. Therapeutic options for patients with type 2 diabetes and end-stage renal disease (ESRD) are, however, limited because the reduced glomerular filtration rate results in the accumulation of certain drugs and/ or their metabolites [1]. Conventional oral hypoglyce- Abstract. The potent and selective dipeptidyl peptidase-4 inhibitor vildagliptin improves glycemic control in patients with type 2 diabetes through incretin hormone-mediated increases in both α-and β-cell responsiveness to glucose. We conducted a prospective, open-label, parallel group, controlled study of 51 patients with type 2 diabetic patients undergoing hemodialysis (HD) during the 24-week study period. Patients were assigned to two groups: the vildagliptin group (n = 30) and the control group (n = 21). Vildagliptin was administered at 50 mg/day for the first 8 weeks. Then doses were titrated by dose-doubling to a maximum of 100 mg/day if hemoglobin A1c (HbA1c) or glycated albumin (GA) target levels had not been reached. No vildagliptin was administered to the controls. The average final dose of vildagliptin was 80 ± 5 mg daily. After 24 weeks, vildagliptin had decreased average HbA1c levels from 6.7 % baseline to 6.1 %, average GA levels from 24.5 % baseline to 20.5 % and average postprandial plasma glucose levels from 186 mg/dL baseline to 140 mg/dL (all p < 0.0001). In the control group, we observed no such changes. Vildagliptin efficacy did not differ according to age or body mass index, but the GA reduction was significantly greater in the anti-diabetic agents-naïve group. Furthermore, in patients with higher baseline GA levels, a higher vildagliptin dosage was required to produce a noticeable effect. No serious adverse effects such as hypoglycemia or liver impairment were observed in any patient. Vildagliptin was effective as a treatment for diabetic patients undergoing HD.

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“…Oral Antihyperglycemic Agents: [110] Metformin, thiazolidinediones and acarbose will lower risk for type 2 diabetes mellitus in people with IFG or IGT. The nonsulfonylurea insulin secretagogues repaglinide and nateglinide can be used in renal failure without dose adjustments.…”

Section: Treatment Of Elevated Blood Glucosementioning

confidence: 99%