Effects and Safety of Linagliptin as an Add-on Therapy in Advanced-Stage Diabetic Nephropathy Patients Taking Renin–Angiotensin–Aldosterone System Blockers

Yuichiro Ueda; Hiroki Ishii; Taisuke Kitano; Mitsutoshi Shindo; Haruhisa Miyazawa; Kiyonori Ito; Keiji Hirai; Yoshio Kaku; Honami Mori; Taro Hoshino; Susumu Ookawara; Masafumi Kakei; Kaoru Tabei; Yoshiyuki Morishita

doi:10.33393/dti.2016.1422

Authors

Yuichiro Ueda Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medial University, Saitama, Japan.
Hiroki Ishii Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medial University, Saitama, Japan.
Taisuke Kitano Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medial University, Saitama, Japan.
Mitsutoshi Shindo Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medial University, Saitama, Japan.
Haruhisa Miyazawa Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medial University, Saitama, Japan.
Kiyonori Ito Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medial University, Saitama, Japan.
Keiji Hirai Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medial University, Saitama, Japan.
Yoshio Kaku Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medial University, Saitama, Japan.
Honami Mori Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medial University, Saitama, Japan.
Taro Hoshino Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medial University, Saitama, Japan.
Susumu Ookawara Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medial University, Saitama, Japan.
Masafumi Kakei Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medial University, Saitama, Japan.
Kaoru Tabei Minamiuonuma Hospital, Niigata, Japan.
Yoshiyuki Morishita Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medial University, Saitama, Japan.

DOI:

https://doi.org/10.33393/dti.2016.1422

Keywords:

linagliptin, diabetic nephropathy, renin–angiotensin–aldosterone system blockers, glucose and lipid metabolism, renal function

Abstract

BACKGROUND: We investigated the effects and safety of linagliptin as an add-on therapy in patients with advanced-stage diabetic nephropathy (DMN) taking renin–angiotensin–aldosterone system (RAAS) blockers. METHOD: Twenty advanced-stage DMN patients (estimated glomerular filtration rate (eGFR): 24.5 ± 13.4 mL/min/1.73 m2) taking RAAS blockers were administered 5 mg/day linagliptin for 52 weeks. Changes in glucose and lipid metabolism and renal function were evaluated. RESULTS: Linagliptin decreased glycosylated hemoglobin levels (from 7.32 ± 0.77% to 6.85 ± 0.87%, P , 0.05) without changing fasting blood glucose levels, and significantly decreased total cholesterol levels (from 189.6 ± 49.0 to 170.2 ± 39.2 mg/dL, P , 0.05) and low-density lipoprotein cholesterol levels (from 107.1 ± 32.4 to 90.2 ± 31.0 mg/dL, P , 0.05) without changing high-density lipoprotein cholesterol and triglyceride levels. Urine protein/creatinine ratio and annual change in eGFR remained unchanged. No adverse effects were observed. CONCLUSION: Linagliptin as an add-on therapy had beneficial effects on glucose and lipid metabolism without impairment of renal function, and did not have any adverse effects in this population of patients with advanced-stage DMN taking RAAS blockers.