Diabetes Obes Metab: The effect of dipeptidyl peptidase-4 inhibitor linagliptin and sulfonylurea glimepiride in postprandial renal hemodynamics in adult patients with type 2 diabetes

Background: A protein-rich diet will increase the glomerular filtration rate (GFR) by about 40%-100%.
This phenomenon is called "postprandial hyperfiltration"
.

This renal hemodynamic response to nutrient intake reaches its peak after 60-120 minutes and lasts for several hours, independent of arterial pressure

The mediators that may cause postprandial hyperfiltration include absorbed glucose and amino acids, vasoactive substances, neural pathways, and intrarenal mechanisms (for example, glomerular feedback [TGF])

Materials and methods: A randomized, double-blind, parallel grouped intervention trial was used.
The main goal of the trial was to evaluate the effects of 8 weeks of linagliptin and glimepiride on fasting renal hemodynamics (ie, measured GFR and ERPF).
Influence
.

Linagliptin 5 mg (N=10) or glimepiride 1 mg (N=13) was given to overweight T2D patients without renal damage as the second-line treatment of metformin, once a day for a total of 8 weeks

Results: Compared with glimepiride, linagliptin increased postprandial glomerular filtration fraction (FF; average difference of 2.
1% points; P= 0.
016) and intra-glomerular pressure (average difference of 3.
0 mmHg; P = 0.
050), from baseline to week 8 estimated GFR (P = 0.
08) and arteriolar resistance (R _E , P = 0.
08) have an increasing trend
.

There is no significant difference in FE

Compared with glimepiride, linagliptin increased the postprandial glomerular filtration fraction and intraglomerular pressure from baseline to the 8th week.

Figure 1 The effects of linagliptin and glimepiride on A, postprandial blood glucose, B, insulin, C, glucagon and D, intact glucagon-like peptide-1 (GLP-1)

Figure 1 The effects of linagliptin and glimepiride on A, postprandial blood glucose, B, insulin, C, glucagon and D, intact glucagon-like peptide-1 (GLP-1)

Table The effects of linagliptin and glimepiride treatment on renal physiology after meals

Table The effects of linagliptin and glimepiride treatment on renal physiology after meals

Figure 2 Treatment of linagliptin and glimepiride on renal hemodynamic function after meal (A, glomerular filtration rate; B, effective renal plasma flow; C, filtration fraction; D, glomerular water Pressure; E, resistance of incoming arterioles; F, resistance of outgoing arterioles) response

Figure 2 Treatment of linagliptin and glimepiride on renal hemodynamic function after meal (A, glomerular filtration rate; B, effective renal plasma flow; C, filtration fraction; D, glomerular water Pressure; E, resistance of incoming arterioles; F, resistance of outgoing arterioles) response

Conclusion: with our hypothesis contrary, compared with glimepiride, linagliptin did not reduce postprandial filtration, but it seems that by increasing blood pressure, or R _E increased postprandial FF
.

In contrast with our hypothesis, compared to glimepiride, it did not reduce postprandial linagliptin filtration, but it seems that by increasing blood pressure, or R & lt _E increased postprandial the FF
.

_E

Original source:

Muskiet MHA, Tonneijck L, Smits MM,et al.

Postprandial renal hemodynamic effects of DPP-4 inhibitor linagliptin versus sulfonylurea glimepiride in adults with type 2 diabetes (RENALIS): a pre-defined sub-study of a randomized, double-blind trial in this message