Clarifying the relationship between metformin, acute kidney injury and lactic acidosis

Bell, Samira; Soto-Pedre, Enrique; Connelly, Paul; Livingstone, Shona; Pearson, Ewan R.

doi:10.1038/nrneph.2017.172

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…In our study, PPIs were not significantly associated with kidney dysfunction in the main analysis but were significantly associated in the subgroup analysis. Furthermore, some evidence in the literature suggests that Metformin 94,95 and statin 96 are not associated with kidney function. Despite the widely-known adverse association of NSAIDs with kidney dysfunction 50,63–66,70 , our study reports no such association.…”

Section: Discussionmentioning

confidence: 99%

Risk of Kidney Dysfunction from Polypharmacy among Older Patients: A Nested Case-Control Study of the South Korean Senior Cohort

Kang

Hong

2019

Sci Rep

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Polypharmacy, the concurrent use of multiple medicines, could increase the risk of kidney dysfunction among older adults because it likely burdens the aging kidneys to excrete multiple pharmaceutical ingredients and their metabolites. This study aimed to examine the relation between polypharmacy and kidney dysfunction among older patients. A nested case-control study was conducted using the National Health Insurance Service – Senior Cohort (NHIS-SC, 2009–2013), representative of the Korean senior population. It consisted of all health insurance claims linked to records of mandatory health examination. Kidney dysfunction was defined as having an eGFR lower than 60, with a decline rate of 10% or more compared to the baseline eGFR. Polypharmacy was defined based on daily counts of pharmaceutical ingredients during one year prior to the case’s event date. It was classified into polypharmacy (five to 10 ingredients) and excessive polypharmacy (10 or more ingredients). After matching case and control groups based on a range of potential confounders, conditional logistic regression was performed incorporating adjustments on disease-specific, medication-specific, and lifestyle-related risk factors. The matching resulted in 14,577 pairs of cases and controls. Exposure to polypharmacy was significantly associated with increase in the risk of kidney dysfunction; i.e., crude model (polypharmacy: OR = 1.572, 95% CI = 1.492–1.656; excessive polypharmacy: OR = 2.069, 95% CI = 1.876–2.283) and risk adjustment model (polypharmacy: OR = 1.213, 95% CI = 1.139–1.292; excessive polypharmacy: OR = 1.461, 95% CI = 1.303–1.639). The significant associations were robust across different definitions of kidney dysfunction. These findings inform healthcare providers and policy makers of the importance of polypharmacy prevention to protect older adults from kidney dysfunction.

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Section: Discussionmentioning

confidence: 99%

Risk of Kidney Dysfunction from Polypharmacy among Older Patients: A Nested Case-Control Study of the South Korean Senior Cohort

Kang

Hong

2019

Sci Rep

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“…Nephrol. http://dx.doi.org/10.1038/nrneph.2017.172 (2017)) 2 , and we would like to respond to their important points.…”

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confidence: 99%

Further clarifying the relationship between metformin, acute kidney injury and lactic acidosis

Rhee

Kalantar-Zadeh

2018

Nat Rev Nephrol

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Klotho Deficiency in Severe COVID-19: A Unifying Hypothesis

Campos-Obando,

Zillikens,

Macaya

2024

COVID

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COVID-19 is characterized by a striking similarity to premature aging. Its clinical manifestations range from asymptomatic to critical illness. No single central agent has been demonstrated so far. We present Klotho, an antiaging protein, as a key factor in COVID-19 pathophysiology. There is epidemiological evidence that both acute and chronic uses of Klotho agonists have a beneficial effect in reducing COVID-19 severity and mortality. A review of the PubMed epidemiological, clinical, and mechanistic evidence supports a role for Klotho deficit as a central determinant of severe COVID-19. Clinical data support the idea that chronic use of Klotho agonists protects against severe COVID-19 and that its acute use may be beneficial. We propose a unifying hypothesis that low Klotho levels play a key role in severe COVID-19, while increasing Klotho levels can have a beneficial effect through the prevention of acute kidney injury (AKI) and potential antiviral effects. Further research is needed.

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Clarifying the relationship between metformin, acute kidney injury and lactic acidosis

Cited by 3 publications

References 5 publications

Risk of Kidney Dysfunction from Polypharmacy among Older Patients: A Nested Case-Control Study of the South Korean Senior Cohort

Risk of Kidney Dysfunction from Polypharmacy among Older Patients: A Nested Case-Control Study of the South Korean Senior Cohort

Further clarifying the relationship between metformin, acute kidney injury and lactic acidosis

Klotho Deficiency in Severe COVID-19: A Unifying Hypothesis

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