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2015 ; 6
(6
): 840-9
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Diabetes therapies in hemodialysis patients: Dipeptidase-4 inhibitors
#MMPMID26131325
Nakamura Y
; Hasegawa H
; Tsuji M
; Udaka Y
; Mihara M
; Shimizu T
; Inoue M
; Goto Y
; Gotoh H
; Inagaki M
; Oguchi K
World J Diabetes
2015[Jun]; 6
(6
): 840-9
PMID26131325
show ga
Although several previous studies have been published on the effects of
dipeptidase-4 (DPP-4) inhibitors in diabetic hemodialysis (HD) patients, the
findings have yet to be reviewed comprehensively. Eyesight failure caused by
diabetic retinopathy and aging-related dementia make multiple daily insulin
injections difficult for HD patients. Therefore, we reviewed the effects of DPP-4
inhibitors with a focus on oral antidiabetic drugs as a new treatment strategy in
HD patients with diabetes. The following 7 DPP-4 inhibitors are available
worldwide: sitagliptin, vildagliptin, alogliptin, linagliptin, teneligliptin,
anagliptin, and saxagliptin. All of these are administered once daily with dose
adjustments in HD patients. Four types of oral antidiabetic drugs can be
administered for combination oral therapy with DPP-4 inhibitors, including
sulfonylureas, meglitinide, thiazolidinediones, and alpha-glucosidase inhibitor.
Nine studies examined the antidiabetic effects in HD patients. Treatments
decreased hemoglobin A1c and glycated albumin levels by 0.3% to 1.3% and 1.7% to
4.9%, respectively. The efficacy of DPP-4 inhibitor treatment is high among HD
patients, and no patients exhibited significant severe adverse effects such as
hypoglycemia and liver dysfunction. DPP-4 inhibitors are key drugs in new
treatment strategies for HD patients with diabetes and with limited choices for
diabetes treatment.