title: The treatment of type 2 diabetes mellitus in patients with chronic kidney disease: What to expect from new oral hypoglycemic agents.
abstract: Worldwide, an estimated 200 million people have chronic kidney disease (CKD), whose most common causes include hypertension, arteriosclerosis, and diabetes. About 40% of patients with diabetes develop CKD and intensive blood glucose control through pharmacological intervention can delay CKD progression. Standard therapies for the treatment of type 2 diabetes mellitus include metformin, sulfonylureas, meglitinides, thiazolidinediones, and insulin. While these drugs have an important role in the management of type 2 diabetes, only the thiazolidinedione pioglitazone can be used across the spectrum of CKD (stages 2-5) and without dose adjustment. Newer therapies, particularly dipeptidyl peptidase-IV inhibitors, glucagon-like peptide-1 receptor agonists, and sodium-glucose cotransporter-2 inhibitors, are increasingly being used in the treatment of type 2 diabetes; however, a major consideration is whether these newer therapies can also be used safely and effectively across the spectrum of renal impairment.
authors.affiliation: Department of Nephrology and Dialysis, L. Parodi - Delfino Hospital, Colleferro, Italy. Electronic address: dilulloluca69@gmail.com.
authors.forename: Luca
authors.initials: L
authors.lastname: Di Lullo
authors.affiliation: Department of Health Sciences, S. Paolo Hospital, University of Milan, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Mangano
authors.affiliation: International Renal Research Institute, S. Bortolo Hospital, Vicenza, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
authors.affiliation: Department of Nephrology and Dialysis, L. Parodi - Delfino Hospital, Colleferro, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Barbera
authors.affiliation: Department of Nephrology and Dialysis, V. Fazzi Hospital, Lecce, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: De Pascalis
authors.affiliation: Department of Nephrology and Dialysis, ASST Lariana, S. Anna Hospital, Como, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Bellasi
authors.affiliation: Clinical Nephrology, University Federico II°, Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Russo
authors.affiliation: Department of Nephrology and Dialysis, Landolfi Hospital, Solofra, Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Di Iorio
authors.affiliation: Department of Health Sciences, S. Paolo Hospital, University of Milan, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Cozzolino
mesh_terms: D000284:Administration, Oral; D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000150:complications*
chemical_list: D007004:Hypoglycemic Agents
keywords: Chronic kidney disease; DPP-IV inhibitors; Diabetic nephropathy; GLP-1 agonists; SGLT-2 inhibitors