Metformin therapy and kidney disease: a review of guidelines and proposals for metformin withdrawal around the world

Kajbaf, F.; Arnouts, Paul; Broe, Marc De; Lalau, Jean–Daniel

doi:10.1002/pds.3501

Cited by 42 publications

(34 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this context, it seems essential to consider the role of metformin (the most frequently prescribed drug to patients with Type 2 diabetes mellitus [12]) in CKD for several reasons: (i) metformin is only contraindicated in severe CKD because it clears four to five times more quickly than creatinine [13], (ii) metformin's impressive cardiovascular protective effects should be of particular value in patients with CKD (who therefore have a high cardiovascular risk) [14], (iii) metformin therapy can potentially be continued in severe CKD as long as the latter one is stable and the dose of metformin is adjusted as a function of the severity of kidney disease [15], (iv) assaying for blood metformin should minimize the risk of metformin accumulation, (v) metformin accumulation is not dangerous per se [16], and (vi) metformin may even be protective in lactic acidosis caused by concomitant conditions [17]. …”

Section: Introductionmentioning

confidence: 99%

The Association between 25-Hydroxyvitamin D and Hemoglobin A1c Levels in Patients with Type 2 Diabetes and Stage 1–5 Chronic Kidney Disease

Kajbaf

Mentaverri

Fournier

et al. 2014

International Journal of Endocrinology

Self Cite

View full text Add to dashboard Cite

Aim. To examine the relationship between plasma 25-hydroxyvitamin D (25(OH)D) levels and blood hemoglobin A1c (HbA1c) levels in diabetic patients at various stages of chronic kidney disease (CKD). Methods. We screened for data collected between 2003 and 2012. The correlation between 25(OH)D and HbA1c levels was studied in patients categorized according to the severity of CKD and their vitamin D status. A multivariate linear regression model was used to determine whether 25(OH)D and HbA1c levels were independently associated after adjustment for a number of covariates (including erythrocyte metformin levels). Results. We identified 542 reports from 245 patients. The mean HbA1c value was 6.7 ± 1.0% in vitamin D sufficiency, 7.3 ± 1.5% in insufficiency, and 8.4 ± 2.0% in deficiency (P < 0.0001). There was a negative correlation between 25(OH)D and HbA1c levels for the population as a whole (r = −0.387, P < 0.0001) and in the CKD severity subgroups (r = −0.384, P < 0.0001 and r = −0.333, P < 0.0001 for CKD stages 1–3 and 4-5, resp.). In the multivariate analysis, the 25(OH)D level was the only factor associated with HbA1c (P < 0.0001). Conclusion. 25(OH)D levels were negatively correlated with HbA1c levels independently of study covariates.

show abstract

Section: Introductionmentioning

confidence: 99%

The Association between 25-Hydroxyvitamin D and Hemoglobin A1c Levels in Patients with Type 2 Diabetes and Stage 1–5 Chronic Kidney Disease

Kajbaf

Mentaverri

Fournier

et al. 2014

International Journal of Endocrinology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Kajbaf et al [11] compared guidelines from around the world regarding metformin use in patients with CKD. While most of the guidelines agree on the serum creatinine threshold levels, the estimated glomerular filtration rate (eGFR) threshold values for avoidance of metformin vary.…”

Section: Introductionmentioning

confidence: 99%

Metformin Use in Kidney Transplant Recipients in the United States: An Observational Study

et al. 2014

View full text Add to dashboard Cite

Background/Aims: Although metformin is contraindicated in patients with increased serum creatinine levels (≥1.5 mg/dl in men, ≥1.4 mg/dl in women) in the United States, its use has not been systematically examined in kidney transplant recipients. We aimed to determine the frequency of metformin use and its associations among kidney transplant recipients, and to assess allograft and patient survival associated with metformin use. Methods: In this retrospective cohort study, we linked Scientific Registry of Transplant Recipients data for all incident kidney transplants 2001-2012 and national pharmacy claims (n = 46,914). We compared recipients having one or more pharmacy claims for a metformin-containing product (n = 4,609) and recipients having one or more claims for a non-metformin glucose-lowering agent (n = 42,305). Results: On average, metformin claims were filled later after transplant and were associated with higher estimated glomerular filtration rates before the first claim. Median serum creatinine (mg/dl) levels before the first claim were lower in recipients with metformin claims than in those with non-metformin claims (1.3 [interquartile range 1.0-1.7] vs. 1.6 [1.2-2.5], respectively; p < 0.0001). Metformin was associated with lower adjusted hazards for living donor (0.55, 95% confidence interval 0.38-0.80; p = 0.002) and deceased donor (0.55, 0.44-0.70; p < 0.0001) allograft survival at 3 years posttransplant, and with lower mortality. Conclusions: Despite metformin being contraindicated in renal dysfunction, many kidney transplant recipients receive it, and it is not associated with worse patient or allograft survival.

show abstract

“…Despite the fact that guidelines caution to avoid metformin in patients with mild to moderate CKD, they are not always consistently followed 5. In conclusion, this review supports consideration of a change to the prescribing guidelines of metformin, with cautious use allowed in patients with mild to moderate CKD, as already accepted in many less restrictive policy revisions outside the USA 1–3 7…”

Section: Commentarymentioning

confidence: 75%

Metformin should not be contraindicated in patients with type 2 diabetes and mild to moderate renal impairment

Scheen

2015

Evid Based Med

View full text Add to dashboard Cite

Metformin therapy and kidney disease: a review of guidelines and proposals for metformin withdrawal around the world

Cited by 42 publications

References 32 publications

The Association between 25-Hydroxyvitamin D and Hemoglobin A1c Levels in Patients with Type 2 Diabetes and Stage 1–5 Chronic Kidney Disease

The Association between 25-Hydroxyvitamin D and Hemoglobin A1c Levels in Patients with Type 2 Diabetes and Stage 1–5 Chronic Kidney Disease

Metformin Use in Kidney Transplant Recipients in the United States: An Observational Study

Metformin should not be contraindicated in patients with type 2 diabetes and mild to moderate renal impairment

Contact Info

Product

Resources

About