Table 4.
Adjustment of Incretin Treatment in Chronic Kidney Disease
| Dose Adjustment for CKD 3–5 (*eGFR <30ml/min/1.73m2) | |
|---|---|
| GLP- 1 RA | |
| Dulaglutide | No dose adjustment |
| Exenatide | CrCl 30–50: caution with initiating or increasing the dose CrCl < 30: use not recommended If using a once weekly preparation: eGFR < 45: use not recommended |
| Liraglutide | No dose adjustment |
| Lixisenatide | eGFR 30–60: no adjustment necessary eGFR 15–29: monitoring of kidney function and gastrointestinal side effects is recommended eGFR < 15: use not recommended |
| Semaglutide | No dose adjustment |
| DPP-4 inhibitors | |
| Alogliptin | CrCl 30 −59: decrease to 12.5 mg orally daily CrCl < 30: decrease to 6.25 mg orally daily |
| Linagliptin | No dose adjustment required |
| Saxagliptin | eGFR < 45: decrease to 2.5 mg orally daily |
| Sitagliptin | eGFR 30–45: decrease to 50 mg orally daily eGFR < 30: decrease to 25 mg orally daily |
Notes: *eGFR, estimated glomerular filtration rate in ml/min/1.73m2.
Abbreviations: GLP-1 RA, glucagon-like peptide 1 receptor agonist; CrCl, creatinine clearance; DPP-4, dipeptidyl peptidase IV; mg, milligrams.