Is the combination of linagliptin and allopurinol better prophylaxis against post-contrast acute kidney injury? A multicenter prospective randomized controlled study
BACKGROUND: Patients with diabetic kidney disease (DKD) are at increased risk to develop post-contrast acute kidney injury (AKI). Diabetic patients under dipeptidyl peptidase 4 inhibitors (DPP4Is) experience a lower propensity to develop AKI. We speculated that linagliptin as a single agent or in combination with allopurinol may reduce the incidence of post-contrast AKI in stage 3-5 chronic kidney disease (CKD) patients with underlying DKD.
METHODS: Out of 951 DKD patients eligible for this study, 800 accepted to sign informed consent. They were randomly allocated to 4 equal groups that received their prophylaxis for 2 days before and after radiocontrast. The first control group received N-acetyl cysteine and saline, the 2nd received allopurinol, the 3rd group received linagliptin, and the 4th received both allopurinol and linagliptin. Post-procedure follow-up for kidney functions was conducted for 2 weeks in all patients.
RESULTS: 20, 19, 14, and 8 patients developed post-contrast AKI in groups 1 through 4, respectively. Neither linagliptin nor allopurinol was superior to N-acetyl cysteine and saline alone. However, the combination of the two agents provided statistically significant renal protection: post-contrast AKI in group 4 was significantly lower than in groups 1 and 2 (p < 0.02 and <0.03, respectively). None of the post-contrast AKI cases required dialysis.
CONCLUSION: Linagliptin and allopurinol in combination may offer protection against post-contrast AKI in DKD exposed to radiocontrast. Further studies are needed to support this view.
TRIAL REGISTRATION CLINICALTRIALS.GOV: NCT03470454.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:45 |
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| Enthalten in: |
Renal failure - 45(2023), 1 vom: 15. Dez., Seite 2194434 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Fayed, Ahmed [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 30.03.2023 Date Revised 31.03.2023 published: Print ClinicalTrials.gov: NCT03470454 Citation Status MEDLINE |
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| doi: |
10.1080/0886022X.2023.2194434 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM354796437 |
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| 100 | 1 | |a Fayed, Ahmed |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Is the combination of linagliptin and allopurinol better prophylaxis against post-contrast acute kidney injury? A multicenter prospective randomized controlled study |
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| 500 | |a Date Completed 30.03.2023 | ||
| 500 | |a Date Revised 31.03.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a ClinicalTrials.gov: NCT03470454 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Patients with diabetic kidney disease (DKD) are at increased risk to develop post-contrast acute kidney injury (AKI). Diabetic patients under dipeptidyl peptidase 4 inhibitors (DPP4Is) experience a lower propensity to develop AKI. We speculated that linagliptin as a single agent or in combination with allopurinol may reduce the incidence of post-contrast AKI in stage 3-5 chronic kidney disease (CKD) patients with underlying DKD | ||
| 520 | |a METHODS: Out of 951 DKD patients eligible for this study, 800 accepted to sign informed consent. They were randomly allocated to 4 equal groups that received their prophylaxis for 2 days before and after radiocontrast. The first control group received N-acetyl cysteine and saline, the 2nd received allopurinol, the 3rd group received linagliptin, and the 4th received both allopurinol and linagliptin. Post-procedure follow-up for kidney functions was conducted for 2 weeks in all patients | ||
| 520 | |a RESULTS: 20, 19, 14, and 8 patients developed post-contrast AKI in groups 1 through 4, respectively. Neither linagliptin nor allopurinol was superior to N-acetyl cysteine and saline alone. However, the combination of the two agents provided statistically significant renal protection: post-contrast AKI in group 4 was significantly lower than in groups 1 and 2 (p < 0.02 and <0.03, respectively). None of the post-contrast AKI cases required dialysis | ||
| 520 | |a CONCLUSION: Linagliptin and allopurinol in combination may offer protection against post-contrast AKI in DKD exposed to radiocontrast. Further studies are needed to support this view | ||
| 520 | |a TRIAL REGISTRATION CLINICALTRIALS.GOV: NCT03470454 | ||
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| 700 | 1 | |a Hammad, Ahmed A |e verfasserin |4 aut | |
| 700 | 1 | |a Abdulazim, Dina O |e verfasserin |4 aut | |
| 700 | 1 | |a Hammad, Hany |e verfasserin |4 aut | |
| 700 | 1 | |a Amin, Mohamed |e verfasserin |4 aut | |
| 700 | 1 | |a Elhadidy, Samir |e verfasserin |4 aut | |
| 700 | 1 | |a Salem, Mona M |e verfasserin |4 aut | |
| 700 | 1 | |a ElAzim, Ibrahim M Abd |e verfasserin |4 aut | |
| 700 | 1 | |a Zsom, Lajos |e verfasserin |4 aut | |
| 700 | 1 | |a Csongradi, Eva |e verfasserin |4 aut | |
| 700 | 1 | |a Soliman, Karim M |e verfasserin |4 aut | |
| 700 | 1 | |a Sharaf El Din, Usama A |e verfasserin |4 aut | |
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