Oral antidiabetic agents: how much kidney disease can we tolerate?

Authors: Mayer, Christof; Holstein, Andreas; Stumvoll, Michael

Source: Expert Review of Endocrinology and Metabolism, Volume 2, Number 4, July 2007 , pp. 469-475(7)

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Abstract:

Type 2 diabetes mellitus and chronic kidney disease in mild and moderate stages is a common and underestimated comorbidity with relevant therapeutic consequences. Available oral antidiabetic agents are effectively used in keeping blood glucose levels within the guideline range but long lists of contraindications often limit their use. Chronic kidney disease is a very common reason to withhold or discontinue an oral antidiabetic therapy, precluding many patients from drugs with proven benefit, such as metformin. Often contraindications are not based on data but on theoretical grounds or expert opinion. In this review, we critically review threshold levels of kidney function for common oral antidiabetic agents, the evidence from which they were derived and offer advice on how to monitor kidney function as an important procedure in clinical practice.

Keywords: chronic kidney disease; glomerular filtration rate; oral antidiabetic agents; Type 2 diabetes mellitus; renal failure

Document Type: Research article

DOI: http://dx.doi.org/10.1586/17446651.2.4.469

Publication date: 2007-07-01

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Expert Review of Endocrinology & Metabolism provides extensive coverage of state-of-the-art research and clinical advancements in the field of endocrine control and metabolism, with a focus on screening, prevention, diagnostics, existing and novel therapeutics, as well as related molecular genetics, pathophysiology and epidemiology
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