İleri Evre Kronik Böbrek Hastalarında, Dipeptidl Peptidaz-4 İnhibitörlerinin Böbrek Fonksiyonu Üzerindeki Etkisi

Abstract

Amaç: Bu çalışmada, tahmini glomerüler filtrasyon hızı ve proteinüriye odaklanarak, evre 3-5 kronik böbrek hastalığı olan tip 2 diabetes mellitus hastalarında Dipeptidl Peptidaz-4 nhibitörlerinin böbrek fonksiyonu üzerindeki etkilerini araştırmayı amaçladık. Yöntemler: Çalışma retrospektif vaka kontrol olarak tasarlandı. Veriler tek bir hastanenin yazılımından ve T.C. Sağlık Bakanlığı Ulusal Veri Takip Sisteminden toplanmıştır. Hastalar, vildaglatin kullanan (Müdahele; n=118) ve kullanmayanlar (kontrol; n=48) tip 2 diyabet ve aynı zamanda evre 3-5 kronik böbrek hstalarında oluşturuldu. Temel demografik özellikler, klinik özellikler ve sonuçlar gruplar arasında karşılaştırıldı. Bulgular: Başlangıçta, her iki grup da benzer yaş, cinsiyet dağılımı, vücut kitle indeksi ve tGFH gösterdi. 12 aylık takipte, müdahale grubunda tGFH'da hafif iyileşmeler ve kontrol grubunda hafif azalmalar gözlenirken, bu değişiklikler istatistiksel olarak anlamlı bulunmadı (p>0,05). Proteinüri müdahale grubunda istikrarlı bir eğilim gösterirken, kontrol grubunda anlamlı bir artış kaydedildi (p=0,035). Yaş, tGFH ile anlamlı korelasyon gösterirken (p<0.001) proteinüri ile korelasyon göstermedi (p=0.156). Çalışma da, vildagliptin kullanıcılarının, kontrol grubundaki minimum değişikliklerle karşılaştırıldığında HbA1c düzeylerinde istatistiksel olarak anlamlı bir düşüş (p=0,041) yaşadığını saptandı. Sonuç: Çalışma, tGFH ve proteinüri stabilizasyonundaki eğilimlerin kanıtladığı gibi, ilerlemiş kronik böbrek yetmezliği olan T2DM hastalarında DPP-4 inhibitörlerinin potansiyel renoprotektif etkilerini göstermektedir.

Keywords

• DPP-4 inhibitörleri
• kronik böbrek hastalığı
• proteinüri
• tahmini glomerüler filtasyon hızı
• tip 2 DM.

The Effects of Dipeptidyl Peptidase-4 Inhibitors on Kidney Function in Advanced CKD

Abstract

Objective: This study aimed to investigate the effects of DPP-4 inhibitors on kidney function in type 2 diabetes mellitus patients with stages 3-5 chronic kidney disease, focusing on estimated glomerular filtration rate and proteinuria. Methods: This is a retrospective case-control design, and data were collected from a single hospital's software and the Turkish Ministry of Health's National Data Tracking System. Diabetic patients with T2DM and CKD stages 3-5 were included, with dipeptidyl peptidase-4 inhibitor users (n=118) and non-users (n=48) forming the intervention and control groups, respectively. Baseline demographics, clinical characteristics, and outcomes were compared between groups. Results: At baseline, both groups demonstrated similar age, gender distribution, body mass index, and eGFR. Over a 12-month follow-up, while slight improvements in eGFR were observed in the intervention group and minor reductions in the control group, these changes did not reach statistical significance (p>0.05). Proteinuria showed a stable trend in the intervention group, whereas a significant increase was noted in the control group (p=0.035). Age significantly correlated with eGFR (p<0.001) but not proteinuria (p=0.156). The study found that DPP-4 inhibitor users experienced a statistically significant reduction in HbA1c levels (p=0.041) compared to minimal changes in the control group. Conclusion: The study suggests potential renoprotective effects of DPP-4 inhibitors in T2DM patients with advanced CKD, as evidenced by trends in eGFR and proteinuria stabilization.

Keywords

• Chronic kidney disease
• DPP-4 inhibitors
• eGFR
• proteinuria
• type 2 DM.

Thanks

The authors would like to thank Prof. Dr. Hamad Dheir for his ideas and suggestions for improving the manuscript. Warm thanks to Dr. Fevziye Türkoğlu Genç for her participation in the data collection and preparation of the spreadsheet.

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