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Glitazones in chronic kidney disease: potential and concerns
1CNR-IBIM, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy.
Nutrition, Metabolism, and Cardiovascular Diseases : NMCD
|February 28, 2012
Summary
Glitazones, used for type-2 diabetes, show mixed results for cardiovascular and kidney health in patients with chronic kidney disease (CKD). Further research is needed to determine their overall benefit or risk in this population.
Area of Science:
- Endocrinology
- Nephrology
- Cardiology
Background:
- Glitazones are common hypoglycemic agents for type-2 diabetes.
- Their impact on cardiovascular and renal outcomes in chronic kidney disease (CKD) patients requires clarification.
Purpose of the Study:
- To systematically review cardiovascular and renal outcomes in CKD patients treated with glitazones.
Main Methods:
- Systematic review of randomized clinical trials and meta-analyses.
- Inclusion of observational studies on survival and cardiovascular outcomes.
- Analysis of experimental and clinical studies on renal effects.
Main Results:
- Glitazones (especially rosiglitazone) may increase risks of myocardial infarction, heart failure, and cardiovascular death in type-2 diabetics.
- Observational studies on survival and cardiovascular outcomes in kidney failure patients yield controversial results.
- Glitazones show potential renal benefits by reducing albuminuria and proteinuria in various nephropathies.
Conclusions:
- The net effect of glitazones on major cardiovascular and renal outcomes in diabetic patients with CKD is uncertain.
- Specific clinical trials are necessary to evaluate glitazone efficacy and safety in high-risk CKD populations.
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