10. Cardiovascular Diabetology201716:65
Take care of:
• OVER diuresis (better to avoid diuretics with this combination)
• Dehydration
• NSAIDs
• Hypotension
• Risk of volume depletion
Diabetes Metab Syndr. 2017 Mar 31
12
11. Euglycemic ketoacidosis is an uncommon
complication associated with SGLT-2 inhibitors
• A decrease in insulin levels as a result of insulin-independent
hypoglycemia leading to increased lipolysis
• A primary increase in glucagon secretion via direct effects on SGLT2
transporters expressed in pancreatic alpha cells leading to increased
ketogenesis
Am J Kidney Dis. 2017 Jun;69(6):A11-A13
12
28. Clin J Am Soc Nephrol. 2017 May 8;12(5):744-750.
7
29. Clin J Am Soc Nephrol. 2017 May 8;12(5):744-750.
Regular monitoring of creatine kinase level is suggested
for early detection of febuxostat-associated myopathy,
particularly in patients with CKD.
7
35. it was decided to modify the 2009 recommendation to list
calcimimetic therapy now first, in alphabetical order,
5
36. Talk Outline
• New anti diabetic: SGLT-2 Inhibitors
• Update of old debate:
• Metformin
• Warfarin on hemodialysis
• Gout / Hyperuricemia drug alerts
• CKD – MBD Updates:
• KDIGO 2016
• Etelcalcetide
• Oral NaHCO3 with hemodialysis
• Final message
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37. Expert Opin Pharmacother. 2017 Apr;18(5):529-534.
• A peptide calcimimetic agent that has a similar mechanism
of action as cinacalcet hydrochloride
• FDA approved (February 7th, 2017)
• Injectable with a longer elimination half-life than cinacalcet
• Frequency of gastrointestinal adverse events has been
comparable between cinacalcet and etelcalcetide
4