Actualización del efecto de los antihiperglicemiantes en la función renal en diabetes mellitus tipo 2

Autores/as

  • Jonatan Navarro Solano Caja Costarricense del Seguro Social, Hospital San Juan de Dios
  • Chih Hao Chen Ku Universidad de Costa Rica

DOI:

https://doi.org/10.51481/amc.v60i2.997

Palabras clave:

diabetes mellitus tipo 2, IDPP-4, ISGLT2, metformina, tiazolidinedionas, sulfonilureas, insulina, tasa de filtración glomerular, análogos de GLP-1

Resumen

La diabetes mellitus tipo 2 es una de las enfermedades metabólicas que afecta a diferentes órganos, uno en el cual es el riñón. Una de las principales complicaciones microvasculares es la nefropatía diabética, siendo la principal causa de insuficiencia renal crónica a nivel mundial. De ahí la importancia de las recomendaciones en la utilización o no de los fármacos antihiperglicemiantes, basadas en sus efectos beneficiosos a nivel de la función renal en relación con la tasa de filtración glomerular estimada y la relación albumina/creatinina en pacientes con diabetes mellitus tipo 2 y enfermedad renal. En estudios recientes se han evaluado antihiperglicemiantes con un impacto beneficioso a nivel de desenlaces cardiovascular y renal. En el presente artículo se revisan las acciones y los efectos de los diferentes grupos de medicamentos como la metformina, los inhibidores de la dipeptidil peptidasa 4, los agonistas de la GLP-1, tiazolidinedionas, sulfonilureas, inhibidores del cotransportador de sodio-glucosa tipo 2 e insulinas en la función renal en cuanto a las dosis de cada fármaco, tanto el uso de dosis establecidas, disminución de la dosis o el no uso del medicamento con base en el empeoramiento de la tasa de filtración glomerular estimada. Con respecto a la metodología aplicada para el desarrollo del artículo, se seleccionó artículos a partir de palabras claves como diabetes mellitus tipo 2, antihiperglicemiantes en la función renal, tasa de filtración glomerular estimada y relación albumina/creatinina; se emplearon artículos de revistas reconocidas que no superaran 5 años en su publicación, sin embargo, se utilizaron artículos que superaran este tiempo, dado que aportaban datos importantes para el artículo de revisión. 

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Sharma D, Bhattacharya P, Kalia K, Tiwari V et al. Diabetic Nephropathy: New insights into established therapeutic paradigms and novel molecular targets. Diabetes Res Clin Pract. 2017; 128:91-108.

Duran M., Rubio A. Diabetic nephropathy and inflammation. World J Diabetes. 2014 June 15; 5: 393-398.

Tonneijck L, Muskiet M, Smits M, Van Bommel E, Heerspink H, Raalte D, Joles J. et al. Glomerular Hyperfiltration in Diabetes: Mechanisms, Clinical Significance, and Treatment. J Am Soc Nephrol.2017; 28: 1023–1039.

Levey A, Stevens L. Estimating GFR Using the CKD Epidemiology Collaboration

(CKDEPI) Creatinine Equation: More Accurate GFR Estimates, Lower CKD Prevalence Estimates, and Better Risk Predictions. Am J Kidney Dis. 2010; 55: 622–627.

Wood A, Churilov L, Perera N, Thomas D, Poon A, MacIsaac R, et al. Estimating glomerular filtration rate: Performance of the CKD-EPI equation over time in patients with type 2 diabetes. Journal of Diabetes and its Complications, vol. 30, no. 1, pp. 49-54.

Cartet-Farnier E, Goutelle-Audibert L, Maire P, De la Gastine B. and Goutelle S. Implications of using the MDRD or CKD-EPI equation instead of the Cockcroft–Gault equation for estimating renal function and drug dosage adjustment in elderly patients. Fundam Clin Pharmacol. 2017; 31: 110–119.

Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Pharmacologic management of type 2 diabetes: 2016 Interim Update. Can J Diabetes. 2016; 40: 484–486.

Bailey CJ, Turner RC. Metformin. N Engl J Med 1996; 334:9 574-9.

Holman R, Paul S, Bethel M, Matthews D, Neil H, et al. 10-Year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 2008; 359:15771589.

Garber A, Abrahamson M, Barzilay J, Blonde L, Bloomgarden Z, Bush M, et al. Consensus statement by the american association of clinical endocrinologists and american college of endocrinology on the comprehensive type 2 diabetes management algorithm. T2D Algorithm, Executive Summary. Endocr Pract. 2017; 23:207-238.

Inzucchi S, Lipska K, Mayo H, Bailey C, McGuire D. Metformin in patients with type 2 diabetes and kidney disease. JAMA. 2014; 312:2668-75.

Cefalu W, Bakris G, Blonde L, Boulton A, Greene E, Hu F, et al. Standards of Medical Care in Diabetes. Diabetes Care. 2017; 40:S4-S5.

The ADVANCE Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 2008; 358:2560-2572.

National Kidney Foundation. KDOQI Clinical Practice Guideline for Diabetes and CKD: 2012 update. Am J Kidney Dis. 2012; 60:850-886.

Schernthaner G, Grimaldi A, Di Mario U, Drzewoski J, Kempler P, M. Kvapil M, et al. GUIDE study: double-blind comparison of once-daily gliclazide MR and glimepiride in type 2 diabetic patients. Eur J Clin Invest. 2004; 34:535-42.

Davis T, Dipeptidyl peptidase-4 inhibitors: pharmacokinetics, efficacy, tolerability and safety in renal impairment. Diabetes Obes Metab. 2014; 16:891-9.

Scirica B, Deepak L, Bhatt D, Braunwald E, Steg P, Davidson J, et al. Saxagliptin and Cardiovascular Outcomes in Patients with Type 2 Diabetes Mellitus. N Engl J Med 2013; 369:1317-1326.

Mosenzon O, Leibowitz G, Bhatt D, Cahn A, Hirshberg B, Wei C, et al. Effect of Saxagliptin on Renal Outcomes in the SAVOR-TIMI 53 Trial. Diabetes Care. 2017; 40:69-76.

Ceriello A, Inagaki N. Pharmacokinetic and pharmacodynamic evaluation of linagliptin for the treatment of type 2 diabetes mellitus, with consideration of Asian patient populations. J Diabetes Investig 2017; 8: 19–28.

Penno G, Garofolo M, Del Prato S. Dipeptidyl peptidase-4 inhibition in chronic kidney disease and potential for protection against diabetes-related renal injury. Nutr Metab Cardiovasc Dis. 2016; 26:361-73.

Engel S, Suryawanshi S, Stevens S, Josse R, Cornel J, Jakuboniene N, on behalf of the TECOS Study Group et al. Safety of Sitagliptin in Patients with Type 2 Diabetes and Chronic Kidney Disease: Outcomes from TECOS. N Engl J Med 2015; 373:232-42.

Lukashevich V, Schweizer A, Shao Q, Groop P, Kothny W. Safety and efficacy of vildagliptin versus placebo in patients with type 2 diabetes and moderate or severe renal impairment: a prospective 24-week randomized placebocontrolled trial. Diabetes Obes Metab. 2011; 13:947-54.

Scholten BJ, Persson F, Rosenlund S, Hovind P, Faber J, Hansen T. The effect of liraglutide on renal function: A randomised clinical trial. Diabetes Obes Metab. 2017; 19:239-247.

Marso S, Daniels G, Brown‑Frandsen K, Kristensen P, Mann J, Nauck M, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2016; 375:311-22.

Mann J, Orsted D, Brown‑Frandsen K, Marso S, Poulter N, Rasmussen S, et al. Liraglutide and Renal Outcomes in Type 2 Diabetes. N Engl J Med 2017; 377:839-48.

Davies M, Bain S, Atkin S, Rossing P, Scott D, Shamkhalova M et al. Efficacy and Safety of Liraglutide Versus Placebo as Add-on to Glucose-Lowering Therapy in Patients With Type 2 Diabetes and Moderate Renal Impairment (LIRA-RENAL): A Randomized Clinical Trial. Diabetes Care. 2016; 39:222-30.

Marbury T, Flint A, Jacobsen J, Karsbøl J, Lasseter K. Pharmacokinetics and tolerability of a single dose of semaglutide, a human glucagon-like peptide-1 analog, in subjects with and without renal impairment. Clin Pharmacokinet. 2017. doi: 10.1007/s40262-017-0528-2.

Marso S, Bain S, Consoli A, Eliaschewitz F, Jódar E, for the SUSTAIN-6 Investigators, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016; 375:1834-44.

Fioretto P, Zambon A, Rossato M, Busetto L, Vettor R. SGLT2 inhibitors and the diabetic kidney. diabetes care. 2016; 39: S165-71.

Scheen A. Pharmacokinetic and Pharmacodynamic Profile of Empagliflozin, a Sodium Glucose Co-Transporter 2 Inhibitor. Clin Pharmacokinet. 2014; 53:213–225.

Wanner C, Inzucchi S, Lachin J, Fitchett D, von Eynatten M, Mattheus M, et al. Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes. N Engl J Med 2016; 375:323-34.

Zinman B, Wanner C, Lachin J, Fitchett D, Bluhmki E, Hantel S, for the EMPAREG OUTCOME Investigators et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015; 373: 2117-28.

Filardi P, Avogaro A, Bonora E, Colivicchi F, Fioretto P, Maggioni A, et al. Mechanisms Linking Empagliflozin to Cardiovascular and Renal Protection. Int J Cardiol. 2017; 241:450-456.

Inagaki N, Kondo K, Yoshinari T, Ishii M, Sakai M, Kuki H, et al. Pharmacokinetic and Pharmacodynamic Profiles of Canagliflozin in Japanese Patients with Type 2 Diabetes Mellitus and Moderate Renal Impairment. Clin Drug Investig. 2014; 34:731–742.

Neal B, Perkovic V, Mahaffey K, De Zeeuw D, Fulcher G, Erondu N, et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med 2017; 377:644-657.

Heerspink H, Desai M, Jardine M, Balis D, Meininger G, Perkovic V, et al. Canagliflozin slows progression of renal function decline independently of glycemic effects. J Am Soc Nephrol. 2017; 28:368-375.

Desai M, Yavin Y, Balis D, Sun D, Canovatchel J, Rosenthal N, et al. Renal safety of canagliflozin, a sodium glucose co-transporter 2 inhibitor, in patients with type 2. Diabetes Obes Metab. 2017; 19:897-900.

Filippatos T, Liberopoulos E, Elisaf M. Dapagliflozin in patients with type 2 diabetes mellitus. Ther Adv Endocrinol Metab 2015, 6:29– 41.

Fioretto P, Stefansson B, Johnsson E, Sjöström C. Dapagliflozin reduces albuminuria over 2 years in patients with type 2 diabetes mellitus and renal impairment. Diabetologia. 2016; 59:2036-9.

Kohan D, Fioretto P, Weihua Tang W, List J. Long-term study of patients with type 2 diabetes and moderate renal impairment shows that dapagliflozin reduces weight and blood pressure but does not improve glycemic control. Kidney Int. 2014; 85:962-71.

Ochodnicky P, Mesarosova L, Cernecka H, Klimas J, Krenek P, Goris M, et al. Pioglitazone, PPARγ agonist, provides comparable protection to angiotensin converting enzyme inhibitor ramipril against adriamycin nephropathy in rat. Eur J Pharmacol. 2014; 730:51-60.

Chang Y, Hwu D, Chang D, Wang An L, Hsun Hsieh C, Jiunn Lee Y, et al. Renal function preservation with pioglitazone or with basal insulin as an addon therapy for patients with type 2 diabetes mellitus. Acta Diabetol. 2017; 54:561-568.

Snyder R, S. Berns J. Use of Insulin and Oral Hypoglycemic Medications in Patients with Diabetes Mellitus and Advanced Kidney Disease. Semin Dial. 2004; 17:365-70.

Neumiller J, Alicic R, Tuttle K. Therapeutic Considerations for Antihyperglycemic Agents in Diabetic Kidney Disease. J Am Soc Nephrol. 2017; 28:2263-2274.

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2018-05-03 — Actualizado el 2018-05-03

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Cómo citar

Solano, J. N., & Ku, C. H. C. (2018). Actualización del efecto de los antihiperglicemiantes en la función renal en diabetes mellitus tipo 2. Acta Médica Costarricense, 60(2), 6–14. https://doi.org/10.51481/amc.v60i2.997