Amongst the globally marketed DPP-4 inhibitors, linagliptin is of particular interest with respect to pleiotropic renoprotective effects as it is the only such drug to be excreted predominantly by non-renal pathways [21]; hence it does not require dose adjustment for chronic kidney disease (or any other intrinsic or extrinsic factor) [20,22,23]. Here, DPP4 is linked to chronic kidney disease.