Effects of Alogliptin on hypertensive chronic kidney disease with Type 2 diabetes mellitus
مايو 03, 2018
Publisher: Australasian medical journal
Background: Diabetes mellitus(DM)is a leading cause of chronic kidney disease (CKD). Theantihyperglycemic treatment options for patients with Type 2 DM are limited because of safety and tolerability concerns. Aims: To retrospectively assess the effect of using Alogliptin; a dipeptidyl peptidase-4 inhibitor (DPP-4i) alongwith conventional gliclazide: a sulphonylurea (SU) on renal outcomes and glycaemiccontrol in T2DM patients with mildCKDand hypertension. Methods: A total of 76 patient records (38 males and 38 females) of patient ages 40–60 were analysed from the kidney unit at Punjab Care hospital, Lahore, Pakistan. All patients had a confirmed history of T2DM with mild CKD and established hypertension.Eligible patients were divided into two groups of 38 individuals each. Group SU received gliclazide monotherapy (SU) or Alogliptin (DPP-4i)+gliclazide (SU) add on therapy. All patients were followed up for 12 months.ResultsThe alogliptin (DPP-4i) plus gliclazide (SU) add on therapy group, in comparison to the group only receiving gliclazide (SU), showed a significant difference in eGFR values. The mean±SD GFR values post 12 months were 74.8±0.31(95%CI:74.8±0.09;74.7–74.9) and 76.1±0.25(95%CI: 76.1±0.08;76.0-76.2) for SU vs.SU+DPP-4i, respectively, with mean calculated effect size of 1.6,.HbA1c, 1,5 AG and ipid profile values have significantly changed(p<0.05) while blood pressure values showed no change. The mean±SD systolic blood pressure readings post 12 months for for SU vs.SU+DPP-4i were 131.4±10.4 (95% CI 131.4±3.3;128.1–134.7), and 131.8±9.9 (95%CI 131.8±3; 128.8–134.8), respectively. Conclusion: In the present study, patients using alogliptin in addition to sulfonyl urea showed improved glycaemic control and lipid profile without increased occurrence of hypoglycaemia. We concluded that, DPP-4iinhibitors are safe treatment options for patients with type 2 diabetes and mild degree of renal impairment.