title: Effects and Safety of Linagliptin as an Add-on Therapy in Advanced-Stage Diabetic Nephropathy Patients Taking Renin-Angiotensin-Aldosterone System Blockers.
abstract: BACKGROUND
  We investigated the effects and safety of linagliptin as an add-on therapy in patients with advanced-stage diabetic nephropathy (DMN) taking renin-angiotensin-aldosterone system (RAAS) blockers.
  
  
  METHODS
  Twenty advanced-stage DMN patients (estimated glomerular filtration rate (eGFR): 24.5 ± 13.4 mL/min/1.73 m(2)) taking RAAS blockers were administered 5 mg/day linagliptin for 52 weeks. Changes in glucose and lipid metabolism and renal function were evaluated.
  
  
  RESULTS
  Linagliptin decreased glycosylated hemoglobin levels (from 7.32 ± 0.77% to 6.85 ± 0.87%, P < 0.05) without changing fasting blood glucose levels, and significantly decreased total cholesterol levels (from 189.6 ± 49.0 to 170.2 ± 39.2 mg/dL, P < 0.05) and low-density lipoprotein cholesterol levels (from 107.1 ± 32.4 to 90.2 ± 31.0 mg/dL, P < 0.05) without changing high-density lipoprotein cholesterol and triglyceride levels. Urine protein/creatinine ratio and annual change in eGFR remained unchanged. No adverse effects were observed.
  
  
  CONCLUSIONS
  Linagliptin as an add-on therapy had beneficial effects on glucose and lipid metabolism without impairment of renal function, and did not have any adverse effects in this population of patients with advanced-stage DMN taking RAAS blockers.
authors.affiliation: Division of Nephrology.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Ueda
authors.affiliation: Division of Nephrology.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Division of Nephrology.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Kitano
authors.affiliation: Division of Nephrology.
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Shindo
authors.affiliation: Division of Nephrology.
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Miyazawa
authors.affiliation: Division of Nephrology.
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Ito
authors.affiliation: Division of Nephrology.
authors.forename: Keiji
authors.initials: K
authors.lastname: Hirai
authors.affiliation: Division of Nephrology.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kaku
authors.affiliation: Division of Nephrology.
authors.forename: Honami
authors.initials: H
authors.lastname: Mori
authors.affiliation: Division of Nephrology.
authors.forename: Taro
authors.initials: T
authors.lastname: Hoshino
authors.affiliation: Division of Nephrology.
authors.forename: Susumu
authors.initials: S
authors.lastname: Ookawara
authors.affiliation: Division of Endocrinology and Metabolism, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medial University, Saitama, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kakei
authors.affiliation: Minamiuonuma Hospital, Niigata, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Tabei
authors.affiliation: Division of Nephrology.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Morishita
keywords: diabetic nephropathy; glucose and lipid metabolism; linagliptin; renal function; renin–angiotensin–aldosterone system blockers