Treating type 2 diabetes in renal insufficiency: the role of pioglitazone.
The advent of new antidiabetic drugs is of special importance for diabetic patients with already impaired renal function since renal insufficiency is a relative or absolute contraindication for several of the established hypoglycemic drugs. Pioglitazone is a novel oral hypoglycemic agent that increases insulin responsiveness in target tissues. Pioglitazone and its active metabolites are excreted mainly via the liver. Drug exposure remains almost constant across a wide range of renal function since there is no accumulation of the drug or its active metabolites during repeated dosing in renal insufficiency. The pharmacokinetic properties of pioglitazone are ideally suited for patients with renal insufficiency. Although there are possible side effects (mainly fluid retention and weight gain and--very rarely--hepatotoxicity). Pioglitazone has a good safety profile in diabetic patients with impaired renal function.
Fritsche
L
L
Department of Nephrology, Charité Campus Mitte, Berlin, Germany. Lutz.Fritsche@charite.de
Budde
K
K
Glander
P
P
Einecke
G
G
Diekmann
F
F
Schötschel
R
R
Neumayer
H H
HH
D019540:Area Under Curve; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000378:metabolism / Q000517:prevention & control*; D006801:Humans; D007004:Hypoglycemic Agents / Q000378:metabolism / Q000493:pharmacokinetics / Q000627:therapeutic use; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D008657:Metabolic Clearance Rate; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000378:metabolism / Q000493:pharmacokinetics / Q000627:therapeutic use
D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077205:Pioglitazone