Effect of alogliptin on hypertensive chronic kidney disease patients with type 2 diabetes mellitus

Amira S. A. Said, N. Hussain, Amal H. I. Al Haddad, F. Javid
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引用次数: 1

Abstract

Background Diabetes mellitus (DM) is a leading cause of chronic kidney disease (CKD). The antihyperglycemic 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) along with conventional gliclazide: a sulphonylurea (SU) on renal outcomes and glycaemic control in T2DM patients with mild CKD and 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. Results The 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-4i inhibitors are safe treatment options for patients with type 2 diabetes and mild degree of renal impairment.
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阿格列汀治疗高血压性慢性肾病合并2型糖尿病的疗效观察
背景糖尿病(DM)是导致慢性肾脏疾病(CKD)的主要原因。由于安全性和耐受性问题,2型糖尿病患者的抗高血糖治疗选择有限。目的回顾性评价阿格列汀的使用效果;二肽基肽酶-4抑制剂(DPP-4i)与常规格列齐特:磺酰脲(SU)对轻度CKD和高血压的T2DM患者的肾脏转归和血糖控制的影响。方法对巴基斯坦拉合尔旁遮普邦护理医院肾脏科76例40-60岁患者(38男38女)的病历进行分析。所有患者都有确诊的T2DM病史,伴有轻度CKD和高血压。符合条件的患者被分为两组,每组38人。SU组接受格列齐特单药治疗(SU)或阿格列汀(DPP-4i)+格列齐特(SU)联合治疗。所有患者均进行了12个月的随访。结果阿格列汀(DPP-4i)加格列齐特(SU)治疗组与单纯接受格列齐特治疗组相比,eGFR值有显著差异。SU与SU+DPP-4i相比,12个月后的平均±SD GFR值分别为74.8±0.31(95%CI:74.8±0.09;74.7–74.9)和76.1±0.25(95%CI:76.1±0.08;76.0-76.2),平均计算效应大小为1.6。HbA1c、1,5 AG和血脂谱值发生了显著变化(p<0.05),而血压值没有变化。SU与SU+DPP-4i在12个月后的平均±SD收缩压读数分别为131.4±10.4(95%CI 131.4±3.3;128.1–134.7)和131.8±9.9(95%CI 1311.8±3;128.8–134.8)。结论在本研究中,除磺酰脲外,使用阿洛列汀的患者血糖控制和血脂状况有所改善,但低血糖的发生率没有增加。我们的结论是,DPP-4i抑制剂是2型糖尿病和轻度肾损伤患者的安全治疗选择。
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Australasian Medical Journal
Australasian Medical Journal MEDICINE, GENERAL & INTERNAL-
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