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Metformin: time to review its role and safety in chronic kidney disease
Metformin: time to review its role and safety in chronic kidney disease
- Source :
- Medical Journal of Australia. 211:37-42
- Publication Year :
- 2019
- Publisher :
- AMPCo, 2019.
-
Abstract
- ■Metformin is recommended as first-line therapy for type 2 diabetes because of its safety, low cost and potential cardiovascular benefits. ■The use of metformin was previously restricted in people with chronic kidney disease (CKD) - a condition that commonly coexists with diabetes - due to concerns over drug accumulation and metformin-associated lactic acidosis. ■There are limited data from observational studies and small randomised controlled trials to suggest that metformin, independent of its antihyperglycaemic effects, may be associated with lower risk of myocardial infarction, stroke and all-cause mortality in people with type 2 diabetes and CKD. ■Research into the risk of metformin-associated lactic acidosis in CKD has previously been limited and conflicting, resulting in significant variation across international guidelines on the safe prescribing and dosing of metformin at different stages of renal impairment. ■Present-day large scale cohort studies now provide supporting evidence for the safe use of metformin in mild to moderate renal impairment (estimated glomerular filtration rate [eGFR] 30-60 mL/min/1.73m2 ). However, prescribing metformin in people with severe renal impairment (eGFR
- Subjects :
- Risk
medicine.medical_specialty
endocrine system diseases
Renal function
Type 2 diabetes
Kidney
urologic and male genital diseases
03 medical and health sciences
0302 clinical medicine
Internal medicine
Diabetes mellitus
medicine
Humans
Hypoglycemic Agents
030212 general & internal medicine
Renal Insufficiency, Chronic
Randomized Controlled Trials as Topic
business.industry
nutritional and metabolic diseases
Type 2 Diabetes Mellitus
General Medicine
medicine.disease
Metformin
medicine.anatomical_structure
Diabetes Mellitus, Type 2
Lactic acidosis
Acidosis, Lactic
business
Glomerular Filtration Rate
Kidney disease
medicine.drug
Subjects
Details
- ISSN :
- 13265377 and 0025729X
- Volume :
- 211
- Database :
- OpenAIRE
- Journal :
- Medical Journal of Australia
- Accession number :
- edsair.doi.dedup.....a606085f84277657fa3ec48d1ff28c9a
- Full Text :
- https://doi.org/10.5694/mja2.50239