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The effects of GLP-1 analogues, DPP-4 inhibitors and SGLT2 inhibitors on the renal system.

Schernthaner G, Mogensen CE, Schernthaner GH - Diab Vasc Dis Res (2014)

Bottom Line: Optimal treatment and prevention of DN may require an early, intensive, multifactorial approach, tailored to simultaneously target all modifiable risk factors.Dipeptidyl peptidase (DPP)-4 inhibitors and sodium-glucose cotransporter 2 (SGLT2) inhibitors lower blood glucose levels without additional risk of hypoglycaemia, and may also reduce albuminuria.Further investigation of the potential renal benefits of DPP-4 and SGLT2 inhibitors is underway.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine I, Rudolfstiftung Hospital, Vienna, Austria guntram.schernthaner@meduniwien.ac.at.

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Related in: MedlinePlus

Changes in eGFR over time in T2DM patients with moderate RI treated with (a) canagliflozin and (b) dapagliflozin. Moderate RI = baseline eGFR ≥30 and <50 mL/min/1.73 m2; Moderate RI = baseline eGFR ≥30 and <60 mL/min/1.73 m2. Placebo (circles, solid line), dapagliflozin 5 mg (squares, dashed line) and dapagliflozin 10 mg (triangles, dotted line).Source: Reprinted by permission from Yale et al.86 ©2013 Blackwell Publishing Ltd; Reprinted by permission from Macmillan Publishers Ltd: Kidney International (Kohan et al.87 Copyright©2014).CANA: canagliflozin; eGFR: estimated glomerular filtration rate; LS: least squares; PBO: placebo; RI: renal impairment; SE: standard error; T2DM: type 2 diabetes mellitus.
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fig4-1479164114542802: Changes in eGFR over time in T2DM patients with moderate RI treated with (a) canagliflozin and (b) dapagliflozin. Moderate RI = baseline eGFR ≥30 and <50 mL/min/1.73 m2; Moderate RI = baseline eGFR ≥30 and <60 mL/min/1.73 m2. Placebo (circles, solid line), dapagliflozin 5 mg (squares, dashed line) and dapagliflozin 10 mg (triangles, dotted line).Source: Reprinted by permission from Yale et al.86 ©2013 Blackwell Publishing Ltd; Reprinted by permission from Macmillan Publishers Ltd: Kidney International (Kohan et al.87 Copyright©2014).CANA: canagliflozin; eGFR: estimated glomerular filtration rate; LS: least squares; PBO: placebo; RI: renal impairment; SE: standard error; T2DM: type 2 diabetes mellitus.

Mentions: Given their mechanism of action, SGLT2 inhibitors may have significant renal effects beyond their glucose-lowering properties.84,85 In patients with T2DM and moderate RI, treatment with canagliflozin (100 or 300 mg for 26 weeks)86 or dapagliflozin (5 or 10 mg for 104 weeks)87 showed an initial transient decrease in eGFR which remained relatively stable for the duration of treatment (Figure 4). The effect of treatment with SGLT2 inhibitors in 6 different studies on renal function are summarised in Table 2.


The effects of GLP-1 analogues, DPP-4 inhibitors and SGLT2 inhibitors on the renal system.

Schernthaner G, Mogensen CE, Schernthaner GH - Diab Vasc Dis Res (2014)

Changes in eGFR over time in T2DM patients with moderate RI treated with (a) canagliflozin and (b) dapagliflozin. Moderate RI = baseline eGFR ≥30 and <50 mL/min/1.73 m2; Moderate RI = baseline eGFR ≥30 and <60 mL/min/1.73 m2. Placebo (circles, solid line), dapagliflozin 5 mg (squares, dashed line) and dapagliflozin 10 mg (triangles, dotted line).Source: Reprinted by permission from Yale et al.86 ©2013 Blackwell Publishing Ltd; Reprinted by permission from Macmillan Publishers Ltd: Kidney International (Kohan et al.87 Copyright©2014).CANA: canagliflozin; eGFR: estimated glomerular filtration rate; LS: least squares; PBO: placebo; RI: renal impairment; SE: standard error; T2DM: type 2 diabetes mellitus.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2 - License 3
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getmorefigures.php?uid=PMC4230539&req=5

fig4-1479164114542802: Changes in eGFR over time in T2DM patients with moderate RI treated with (a) canagliflozin and (b) dapagliflozin. Moderate RI = baseline eGFR ≥30 and <50 mL/min/1.73 m2; Moderate RI = baseline eGFR ≥30 and <60 mL/min/1.73 m2. Placebo (circles, solid line), dapagliflozin 5 mg (squares, dashed line) and dapagliflozin 10 mg (triangles, dotted line).Source: Reprinted by permission from Yale et al.86 ©2013 Blackwell Publishing Ltd; Reprinted by permission from Macmillan Publishers Ltd: Kidney International (Kohan et al.87 Copyright©2014).CANA: canagliflozin; eGFR: estimated glomerular filtration rate; LS: least squares; PBO: placebo; RI: renal impairment; SE: standard error; T2DM: type 2 diabetes mellitus.
Mentions: Given their mechanism of action, SGLT2 inhibitors may have significant renal effects beyond their glucose-lowering properties.84,85 In patients with T2DM and moderate RI, treatment with canagliflozin (100 or 300 mg for 26 weeks)86 or dapagliflozin (5 or 10 mg for 104 weeks)87 showed an initial transient decrease in eGFR which remained relatively stable for the duration of treatment (Figure 4). The effect of treatment with SGLT2 inhibitors in 6 different studies on renal function are summarised in Table 2.

Bottom Line: Optimal treatment and prevention of DN may require an early, intensive, multifactorial approach, tailored to simultaneously target all modifiable risk factors.Dipeptidyl peptidase (DPP)-4 inhibitors and sodium-glucose cotransporter 2 (SGLT2) inhibitors lower blood glucose levels without additional risk of hypoglycaemia, and may also reduce albuminuria.Further investigation of the potential renal benefits of DPP-4 and SGLT2 inhibitors is underway.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine I, Rudolfstiftung Hospital, Vienna, Austria guntram.schernthaner@meduniwien.ac.at.

Show MeSH
Related in: MedlinePlus