Endocrine Abstracts

Introduction: A potent and selective DPP-4 inhibitor improves islet function by enhancing α- and β-cell responsiveness to glucose in the diabetic patients. Renal impairment is a common complication of type 2 diabetes mellitus (T2DM). Vildagliptin is used to treat T2DM as monotherapy or in combination with other antidiabetic drugs, since that it efficiently decreases glycated hemoglobin (HbA1c) values. Additionally, vildagliptin has been shown to be safe in patients with moderately impaired kidney function.

Designs: We studied 107 T2DM patients with diabetic nephropathy, the mean ages are 62.2±10.4 y; early nephropathy stage with microalbuminuria (n=37), apparent nephropathy stage with daily urinary albumin excretion more than 300 mg/g of albumin-creatinine ratio or eGFR less than 60 ml/min (n=50), renal failure stage with increased serum creatinine concentration (n=16) or dialysis stage (n=7). All patients were treated with vildagliptine at least 3 months before entry of this study. We monitored body weight, urine albumin excretion or eGFR of the patients during 6 months.

Results: Vildagliptin-treatment had no influence on the body weight or eGFR in all stages of diabetic nephropathy. In the patients in early nephropathy stage, vildagliptin therapy significantly decreased the concentrations of albumin. Patients in other stages exhibited no differences in concentration of urinary albumin between before and after administration of vildagliptin. There were no severe side-effects of vildagliptin in these patients. Four patients in renal failure stage and 5 dialysis patients were able to convert to monotherapy with vildagliptin from insulin therapy.

Conclusion: Vildagliptin 50 mg qd is well tolerated and efficacious in T2DM patients with severe renal impairment. Otherwise vildagliptin therapy is effective to reduce microalbuminuria in the patients with early diabetic nephropathy.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.