Managing diabetic patients with moderate or severe renal impairment using DPP-4 inhibitors: focus on vildagliptin

Eleonora Russo, Giuseppe Penno, Stefano Del Prato Department of Clinical and Experimental Medicine, Section of Diabetes and Metabolic Disease, Azienda Ospedaliero Universitaria di Pisa, and University of Pisa, Pisa, Italy Background: Dipeptidyl peptidase-4 (DPP-4) inhibitors are novel classified ora...

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Autores principales:	Russo E, Penno G, Del Prato S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/48d2c4b76bb942349b9033e8f089a3d7
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spelling	oai:doaj.org-article:48d2c4b76bb942349b9033e8f089a3d72021-12-02T01:12:09ZManaging diabetic patients with moderate or severe renal impairment using DPP-4 inhibitors: focus on vildagliptin1178-7007https://doaj.org/article/48d2c4b76bb942349b9033e8f089a3d72013-04-01T00:00:00Zhttp://www.dovepress.com/managing-diabetic-patients-with-moderate-or-severe-renal-impairment-us-a12864https://doaj.org/toc/1178-7007Eleonora Russo, Giuseppe Penno, Stefano Del Prato Department of Clinical and Experimental Medicine, Section of Diabetes and Metabolic Disease, Azienda Ospedaliero Universitaria di Pisa, and University of Pisa, Pisa, Italy Background: Dipeptidyl peptidase-4 (DPP-4) inhibitors are novel classified oral anti-diabetic drugs for the treatment of type 2 diabetes mellitus (T2DM) that provide important reduction in glycated hemoglobin, with a low risk for hypoglycemia and no weight gain. In T2DM patients with reduced renal function, adequate glycemic control is essential to delay the progress of kidney dysfunction, but they are at a greater risk of experiencing hypoglycemic events, especially with longer-acting sulfonylureas and meglitinides. Objective: To evaluate vildagliptin as an option to achieve glycemic control in T2DM patients with moderate or severe chronic kidney disease (CKD). Methods: A comprehensive search in the literature was performed using the term "vildagliptin." Original articles and reviews exploring our topic were carefully selected. Results: Vildagliptin provides effective glycemic control in patients with T2DM and CKD. Dose reductions are required for vildagliptin and other DPP-4 inhibitors, except linagliptin, in T2DM patients with moderate-to-severe CKD. Dose of vildagliptin had to be reduced by half (to 50 mg/day) both for moderate (estimated glomerular filtration rate [eGFR] ≥30 to ≤50 mL/min) and severe CKD (eGFR < 30 mL/min). Available results support a favorable efficacy, safety, and tolerability profile for vildagliptin in T2DM with moderate or severe renal failure. Preliminary data may suggest additional benefits beyond improvement of glycemic control. Conclusion: Vildagliptin can be safely used in T2DM patients with varying degrees of renal impairment. Dose adjustments for renal impairment are required. Potential long-term renal benefit of vildagliptin needs to be further explored. Keywords: type 2 diabetes mellitus, renal function, chronic kidney diseaseRusso EPenno GDel Prato SDove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2013, Iss default, Pp 161-170 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Russo E Penno G Del Prato S Managing diabetic patients with moderate or severe renal impairment using DPP-4 inhibitors: focus on vildagliptin
description	Eleonora Russo, Giuseppe Penno, Stefano Del Prato Department of Clinical and Experimental Medicine, Section of Diabetes and Metabolic Disease, Azienda Ospedaliero Universitaria di Pisa, and University of Pisa, Pisa, Italy Background: Dipeptidyl peptidase-4 (DPP-4) inhibitors are novel classified oral anti-diabetic drugs for the treatment of type 2 diabetes mellitus (T2DM) that provide important reduction in glycated hemoglobin, with a low risk for hypoglycemia and no weight gain. In T2DM patients with reduced renal function, adequate glycemic control is essential to delay the progress of kidney dysfunction, but they are at a greater risk of experiencing hypoglycemic events, especially with longer-acting sulfonylureas and meglitinides. Objective: To evaluate vildagliptin as an option to achieve glycemic control in T2DM patients with moderate or severe chronic kidney disease (CKD). Methods: A comprehensive search in the literature was performed using the term "vildagliptin." Original articles and reviews exploring our topic were carefully selected. Results: Vildagliptin provides effective glycemic control in patients with T2DM and CKD. Dose reductions are required for vildagliptin and other DPP-4 inhibitors, except linagliptin, in T2DM patients with moderate-to-severe CKD. Dose of vildagliptin had to be reduced by half (to 50 mg/day) both for moderate (estimated glomerular filtration rate [eGFR] ≥30 to ≤50 mL/min) and severe CKD (eGFR < 30 mL/min). Available results support a favorable efficacy, safety, and tolerability profile for vildagliptin in T2DM with moderate or severe renal failure. Preliminary data may suggest additional benefits beyond improvement of glycemic control. Conclusion: Vildagliptin can be safely used in T2DM patients with varying degrees of renal impairment. Dose adjustments for renal impairment are required. Potential long-term renal benefit of vildagliptin needs to be further explored. Keywords: type 2 diabetes mellitus, renal function, chronic kidney disease
format	article
author	Russo E Penno G Del Prato S
author_facet	Russo E Penno G Del Prato S
author_sort	Russo E
title	Managing diabetic patients with moderate or severe renal impairment using DPP-4 inhibitors: focus on vildagliptin
title_short	Managing diabetic patients with moderate or severe renal impairment using DPP-4 inhibitors: focus on vildagliptin
title_full	Managing diabetic patients with moderate or severe renal impairment using DPP-4 inhibitors: focus on vildagliptin
title_fullStr	Managing diabetic patients with moderate or severe renal impairment using DPP-4 inhibitors: focus on vildagliptin
title_full_unstemmed	Managing diabetic patients with moderate or severe renal impairment using DPP-4 inhibitors: focus on vildagliptin
title_sort	managing diabetic patients with moderate or severe renal impairment using dpp-4 inhibitors: focus on vildagliptin
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/48d2c4b76bb942349b9033e8f089a3d7
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Managing diabetic patients with moderate or severe renal impairment using DPP-4 inhibitors: focus on vildagliptin

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