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作者单位:PD Dr. D. Czock (1)
1. Medizinische Klinik, Abt. Klinische Pharmakologie und Pharmakoepidemiologie, Universit盲tsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland
ISSN:1862-0418
文摘
Background Many antidiabetic drugs have to be adjusted for administration to patients with renal impairment. Objectives Drug dose adjustment of antidiabetic drugs to renal function, specific risks and contraindications. Material and methods Review of current recommendations based on the German summary of product characteristics and published articles from the scientific literature. Results The selection of an antidiabetic drug should be made after individual consideration of expected benefits and potential risks. Metformin is contraindicated in patients with renal impairment. Pioglitazone may be used but a number of potential risks have to be considered. Gliquidone and repaglinide are considered as being kidney-independent. Glucagon-like peptide 1 (GLP-1) analogues should be avoided in patients with severe renal impairment but dipeptidyl peptidase 4 (DPP-4) inhibitors may be used (with dose adjustment). Sodium-glucose linked transporter 2 (SGLT2) inhibitors are inefficient in patients with renal impairment and alpha glucosidase inhibitors are contraindicated in cases of severe renal impairment. Conclusion Oral antidiabetic drugs can also be prescribed for patients with renal impairment but recommended drug dose adjustments and contraindications must be considered.