title: Diabetes therapies in hemodialysis patients: Dipeptidase-4 inhibitors.
abstract: 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.
authors.affiliation: Yuya Nakamura, Masatomo Mihara, Tatsuo Shimizu, Michiyasu Inoue, Yoshikazu Goto, Hiromichi Gotoh, Saiyu Soka Hospital, Kitaya, Soka-city Saitama-ken 340-0046, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Yuya Nakamura, Masatomo Mihara, Tatsuo Shimizu, Michiyasu Inoue, Yoshikazu Goto, Hiromichi Gotoh, Saiyu Soka Hospital, Kitaya, Soka-city Saitama-ken 340-0046, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Hasegawa
authors.affiliation: Yuya Nakamura, Masatomo Mihara, Tatsuo Shimizu, Michiyasu Inoue, Yoshikazu Goto, Hiromichi Gotoh, Saiyu Soka Hospital, Kitaya, Soka-city Saitama-ken 340-0046, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Tsuji
authors.affiliation: Yuya Nakamura, Masatomo Mihara, Tatsuo Shimizu, Michiyasu Inoue, Yoshikazu Goto, Hiromichi Gotoh, Saiyu Soka Hospital, Kitaya, Soka-city Saitama-ken 340-0046, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Udaka
authors.affiliation: Yuya Nakamura, Masatomo Mihara, Tatsuo Shimizu, Michiyasu Inoue, Yoshikazu Goto, Hiromichi Gotoh, Saiyu Soka Hospital, Kitaya, Soka-city Saitama-ken 340-0046, Japan.
authors.forename: Masatomo
authors.initials: M
authors.lastname: Mihara
authors.affiliation: Yuya Nakamura, Masatomo Mihara, Tatsuo Shimizu, Michiyasu Inoue, Yoshikazu Goto, Hiromichi Gotoh, Saiyu Soka Hospital, Kitaya, Soka-city Saitama-ken 340-0046, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Yuya Nakamura, Masatomo Mihara, Tatsuo Shimizu, Michiyasu Inoue, Yoshikazu Goto, Hiromichi Gotoh, Saiyu Soka Hospital, Kitaya, Soka-city Saitama-ken 340-0046, Japan.
authors.forename: Michiyasu
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Yuya Nakamura, Masatomo Mihara, Tatsuo Shimizu, Michiyasu Inoue, Yoshikazu Goto, Hiromichi Gotoh, Saiyu Soka Hospital, Kitaya, Soka-city Saitama-ken 340-0046, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Goto
authors.affiliation: Yuya Nakamura, Masatomo Mihara, Tatsuo Shimizu, Michiyasu Inoue, Yoshikazu Goto, Hiromichi Gotoh, Saiyu Soka Hospital, Kitaya, Soka-city Saitama-ken 340-0046, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Gotoh
authors.affiliation: Yuya Nakamura, Masatomo Mihara, Tatsuo Shimizu, Michiyasu Inoue, Yoshikazu Goto, Hiromichi Gotoh, Saiyu Soka Hospital, Kitaya, Soka-city Saitama-ken 340-0046, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Inagaki
authors.affiliation: Yuya Nakamura, Masatomo Mihara, Tatsuo Shimizu, Michiyasu Inoue, Yoshikazu Goto, Hiromichi Gotoh, Saiyu Soka Hospital, Kitaya, Soka-city Saitama-ken 340-0046, Japan.
authors.forename: Katsuji
authors.initials: K
authors.lastname: Oguchi
keywords: Anti-inflammatory effects; Blood glucose-related factors; Diabetes mellitus; Dipeptidase-4 inhibitors; Hemodialysis