Effects of Combination Treatment on Renal Endothelial Function in Type 2 Diabetes Mellitus
Abstract
Introduction: Recently, we demonstrated that a combination therapy with empagliflozin and linagliptin (E+L) in patients with type 2 diabetes mellitus (T2DM) induce changes in renal hemodynamics. The purpose of the present study was to analyze the influence of nitric oxide (NO) activity of the renal vasculature on the described changes of the renal hemodynamic profile.
Methods: Patients with T2DM were randomized to receive either E+L: (n = 34) or metformin and insulin glargine (M+I: n = 31), for 3 months. Renal hemodynamics were assessed using the constant-infusion input-clearance technique with p-aminohippuric acid for renal plasma flow (RPF) and inulin for glomerular filtration rate (GFR) at baseline and after treatment. Intraglomerular hemodynamics were calculated according to the model established by Gomez. The NO activity in the renal circulation was assessed by analyzing change in RPF in response to i.v. administrated NG-monomethyl-l-arginine (L-NMMA), an NO inhibitor.
Results: After 3 months of treatment, changes in renal hemodynamic parameters were compared with baseline in both groups without any change in renal NO activity. In patients with E+L treatment, we observed a correlation between change in NO activity of the renal vasculature and change in RPF (r = -0.665, P r = 0.439, P = 0.003) and resistance of the efferent postglomerular (RE) arterioles (r = 0.513, P = 0.002) were observed. No such relationships with change in renal NO activity were observed in the M+I…
How strong is the evidence?
Evidence Hub reads this as a randomized trial. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 34 participants or records.
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