Please use this identifier to cite or link to this item: http://hdl.handle.net/2381/38125
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dc.contributor.authorDavies, Melanie-
dc.contributor.authorChatterjee, Sudesna-
dc.contributor.authorKhunti, Kamlesh-
dc.date.accessioned2016-10-04T10:01:42Z-
dc.date.available2016-10-04T10:01:42Z-
dc.date.issued2016-06-23-
dc.identifier.citationClinical Pharmacology: Advances and Applications, 2016, 8, pp. 61-81en
dc.identifier.urihttps://www.dovepress.com/the-treatment-of-type-2-diabetes-in-the-presence-of-renal-impairment-w-peer-reviewed-article-CPAAen
dc.identifier.urihttp://hdl.handle.net/2381/38125-
dc.description.abstractWorldwide, an estimated 200 million people have chronic kidney disease (CKD), the most common causes of which include hypertension, arteriosclerosis, and diabetes. Importantly, ~40% of patients with diabetes develop CKD, yet evidence from major multicenter randomized controlled trials shows that intensive blood glucose control through pharmacological intervention can reduce the incidence and progression of CKD. Standard therapies for the treatment of type 2 diabetes include metformin, sulfonylureas, meglitinides, thiazolidinediones, and insulin. While these drugs have an important role in the management of type 2 diabetes, only the thiazolidinedione pioglitazone can be used across the spectrum of CKD (stages 2-5) and without dose adjustment; there are contraindications and dose adjustments required for the remaining standard therapies. Newer therapies, particularly dipeptidyl peptidase-IV inhibitors, glucagon-like peptide-1 receptor agonists, and sodium-glucose cotransporter-2 inhibitors, are increasingly being used in the treatment of type 2 diabetes; however, a major consideration is whether these newer therapies can also be used safely and effectively across the spectrum of renal impairment. Notably, reductions in albuminuria, a marker of CKD, are observed with many of the drug classes. Dipeptidyl peptidase-IV inhibitors can be used in all stages of renal impairment, with appropriate dose reduction, with the exception of linagliptin, which can be used without dose adjustment. No dose adjustment is required for liraglutide, albiglutide, and dulaglutide in CKD stages 2 and 3, although all glucagon-like peptide-1 receptor agonists are currently contraindicated in stages 4 and 5 CKD. At stage 3 CKD or greater, the sodium-glucose cotransporter-2 inhibitors (dapagliflozin, canagliflozin, and empagliflozin) either require dose adjustment or are contraindicated. Ongoing trials, such as CARMELINA, MARLINA, CREDENCE, and CANVAS-R, will help determine the position of these new therapy classes and if they have renoprotective effects in patients with CKD.en
dc.language.isoenen
dc.publisherDove Medical Pressen
dc.relation.urihttp://www.ncbi.nlm.nih.gov/pubmed/27382338-
dc.rightsCopyright © 2016, Davies et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted use, distribution, and reproduction in any medium non-commercially, provided the original author and source are credited.en
dc.subjectDPP-IV inhibitoren
dc.subjectGLP-1RAen
dc.subjectPKen
dc.subjectSGLT-2 inhibitoren
dc.subjectchronic kidney diseaseen
dc.subjectrenal impairmenten
dc.titleThe treatment of type 2 diabetes in the presence of renal impairment: what we should know about newer therapiesen
dc.typeJournal Articleen
dc.identifier.doi10.2147/CPAA.S82008-
dc.identifier.eissn1179-1438-
dc.description.statusPeer-revieweden
dc.description.versionPublisher Versionen
dc.type.subtypeJournal Article;Review-
pubs.organisational-group/Organisationen
pubs.organisational-group/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGYen
pubs.organisational-group/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicineen
pubs.organisational-group/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cardiovascular Sciencesen
pubs.organisational-group/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Health Sciencesen
pubs.organisational-group/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/Themesen
pubs.organisational-group/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/Themes/Cardiovascularen
pubs.organisational-group/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/Themes/Populationen
dc.dateaccepted2016-03-03-
Appears in Collections:Published Articles, Dept. of Health Sciences

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