1. Metformin therapy in patients with chronic kidney disease.
- Author
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Duong, J. K., Roberts, D. M., Furlong, T. J., Kumar, S. S., Greenfield, J. R., Kirkpatrick, C. M., Graham, G. G., Williams, K. M., and Day, R. O.
- Subjects
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METFORMIN , *TREATMENT of chronic kidney failure , *LACTIC acidosis , *HEMODIALYSIS patients , *STATISTICAL correlation , *SYMPTOMS , *REDUCTION of drug dosage , *DISEASE risk factors - Abstract
Metformin therapy is limited in patients with chronic kidney disease ( CKD) due to the potential risk of lactic acidosis. This open-label observational study investigated metformin and lactate concentrations in patients with CKD (n = 22; creatinine clearances 15-40 ml/min) and in two dialysed patients. Patients were prescribed a range of metformin doses (250-2000 mg daily) and metformin concentrations were compared with data from healthy subjects (scaled to 1500 mg twice daily). A subset of patients (n = 7) was controlled on low doses of metformin (250 or 500 mg daily). No correlation between metformin and lactate concentrations was observed. Three patients had high lactate concentrations (>2.7 mmol/l) and two had high metformin concentrations (3-5 mg/l), but none had any symptoms of lactic acidosis. Reducing metformin dosage and monitoring metformin concentrations will allow the safe use of metformin in CKD, provided that renal function is stable. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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