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- W3045977462 abstract "Linagliptin does not require dose adjustment in diabetes mellitus patients with chronic kidney disease (CKD). But, renal effects of linagliptin are not clear. Our aim was to examine the effect of linagliptin on renal disease progression in only insulin dependent type 2 diabetes mellitus (DM) patients with CKD. Stage 3–4 CKD patients were randomized into 2 groups in this prospective randomized controlled study. In the first group, linagliptin 5 mg was added in addition to the background insulin therapy. In the second group, patients continued their insulin therapy. Patients were followed up at 3-month intervals for one year. The study population consisted of 164 patients (90 patients in linagliptin group, 74 patients in other group) with a mean age of 67.5 ± 8.8 years. eGFR significantly increased in linagliptin group (p = 0.033), but decreased in other group (p = 0.003). No significant change was observed in total insulin dose in linagliptin group (p = 0.111), but in other group, total insulin dose significantly increased (p < 0.001). Proteinuria levels decreased in both groups, but there was no significant change. In the multiple logistic regression analysis, male gender and proteinuria emerged as variables that showed significant association with increased risk and the use of linagliptin emerged as variable that showed significant association with decreased risk for CKD progression. Linagliptin in DM patients with CKD was able to improve renal progression without significant effect on proteinuria and glucose control. With regard to treating diabetic nephropathy, linagliptin may offer a new therapeutic approach. La linagliptina no precisa un ajuste de la dosis en pacientes con diabetes mellitus y enfermedad renal crónica (ERC). No obstante, los efectos renales de la linagliptina no están claros. Nuestro objetivo fue examinar el efecto de la linagliptina en la evolución de la enfermedad renal únicamente en pacientes con diabetes mellitus de tipo 2 insulinodependientes con ERC. En este estudio prospectivo, aleatorizado y controlado, se asignaron de forma aleatoria pacientes con ERC en estadios 3-4 en 2 grupos. En el primer grupo se añadió linagliptina 5 mg además de la insulinoterapia de base. En el segundo grupo, los pacientes siguieron con su insulinoterapia. Los pacientes fueron objeto de seguimiento a intervalos de 3 meses durante un año. La población del estudio estuvo compuesta por 164 pacientes (90 pacientes en el grupo de linagliptina, 74 pacientes en el otro grupo) con una edad media de 67,5 ± 8,8 años. La TFGe aumentó significativamente en el grupo de linagliptina (p = 0,033), pero disminuyó en el otro grupo (p = 0,003). No se observó ningún cambio significativo en la dosis total de insulina en el grupo de la linagliptina (p = 0,111), pero, en el otro grupo, la dosis total de insulina aumentó significativamente (p < 0,001). Los niveles de proteinuria disminuyeron en ambos grupos, pero no hubo cambios significativos. En el análisis de regresión logística múltiple, el género masculino y la proteinuria destacaron como variables que mostraban una asociación significativa con el aumento del riesgo y el uso de la linagliptina destacó como variable con una asociación significativa con la disminución del riesgo de progresión de la enfermedad renal crónica. La linagliptina en pacientes con DM y ERC consiguió mejorar la evolución renal sin un efecto significativo sobre la proteinuria y el control glucémico. En lo que respecta al tratamiento de la nefropatía diabética, la linagliptina puede ofrecer un nuevo enfoque terapéutico." @default.
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- W3045977462 date "2020-11-01" @default.
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- W3045977462 title "The effect of linagliptin on renal progression in type-2 diabetes mellitus patients with chronic kidney disease: A prospective randomized controlled study" @default.
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- W3045977462 doi "https://doi.org/10.1016/j.nefro.2020.04.023" @default.
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