Retrospective evaluation of microalbuminuria and GFR levels of diabetic patients taking DPP-4 Inhibitor, GLP-1 Analog, or SGLT-2 Inhibitor

Year 2022, , 81 - 87, 01.04.2022

Bahriye Gültaş , Özen Özgül , Soner Cander

https://doi.org/10.46310/tjim.1072857

Abstract

Background: In our study, we determined the changes in microalbuminuria and gfr (glomerular filtration rate) values, which are important for diabetic nephropathy, within 1 year after starting treatment in our patients taking DPP-4 inhibitor (linagliptin), GLP-1 analog (exenatide) and SGLT-2 inhibitor (empagliflozin).

Material and Methods: We evaluated the urea, creatinine, gfr and microalbuminuria levels of our patients who were treated with linagliptin, exenatide and empagliflozin on their 0th, 6th and 12th month visits. We included patients who were followed up for nephropathy for at least 1 year after starting treatment in each drug group.

Results: When the 0th and 12th month GFR values of our 98 patients who were prescribed linagliptin were compared, an increase of 4.57% was detected (p<0.01). In this group, there were 55 patients whose microalbuminuria could be followed up at 12 months, and no significant change was detected (p>0.05). While no statistically significant difference was found in the 0th and 12th month GFR follow-ups of our 97 patients using exenatide (p>0.05); in this group, it was determined that the microalbuminuria decreased significantly in 12 months in 33 of our patients who could be followed up in terms of microalbuminuria (p<0.05). No statistically significant change was observed in the 0th and 12th month GFR follow-ups of our 99 patients taking empagliflozin (p>0.05); however, it was determined that microalbuminuria decreased significantly at the end of 1 year in our 79 patients who could be followed up for microalbuminuria in this group (p<0.05).

Conclusions: Although there was no improvement in microalbuminuria in our patients taking linagliptin, an increase in GFR was observed; however, it was observed that this situation was associated with the discontinuation of the nephrotoxic agents used by the patients for the treatment of diabetes and switching to linagliptin. In our patients taking exenatide and Empagliflozin, although no significant change was detected in the GFR value, a decrease in microalbuminuria was observed; this is important in order to prevent the progression of nephropathy in the early period. The results of our study suggest that the use of GLP-1 analog and SGLT-2 inhibitor in diabetic patients will provide a nephroprotective effect.

Keywords

Diabetic nephropathy, Empagliflozin, Exenatide, Linagliptin, Renal failure

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