Renal Protective Effect of DPP-4 Inhibitors in Type 2 Diabetes Mellitus Patients: A Cohort Study

الملخص EN

Aims.

Dipeptidyl-peptidase IV inhibitors (DPP-4i) are among the most popular oral antidiabetic agents.

However, the effects of DPP-4i on diabetic nephropathy are not well-established.

The aim of this study was to determine the renoprotective effects of DPP-4i, using albuminuria and glomerular filtration rate (GFR) as indicators, in type 2 diabetes mellitus (T2DM) patients.

Methods.

This retrospective observational cohort study used the clinical database of a tertiary hospital.

The changes of urine albumin/creatinine ratio (UACR), estimated GFR (eGFR), and metabolic parameters after treatment were compared with the changes of those parameters before treatment using paired Student’s t-test.

Results.

The mean UACR in the entire study population decreased to approximately 45 mg/g 1 year after DPP-4i treatment, while it was increased approximately 39 mg/g 1 year before DPP-4i treatment (p<0.05).

Patients with macroalbuminuria showed a significant reduction in albumin levels after DPP-4i treatment (p<0.05); however, patients with microalbuminuria and normoalbuminuria did not show improvements in albuminuria levels after treatment.

Although eGFR was not changed 1 year after DPP-4i treatment, reductions in eGFR were slowed in patients with microalbuminuria and reversed in the macroalbuminuria or normoalbuminuria groups, 4 years after treatment.

Conclusions.

Administration of DPP-4i reduces urine albumin excretion and mitigates reduction of eGFR in T2DM patients.