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Metformin therapy in patients with chronic kidney disease
Author(s) -
Duong J. K.,
Roberts D. M.,
Furlong T. J.,
Kumar S. S.,
Greenfield J. R.,
Kirkpatrick C. M.,
Graham G. G.,
Williams K. M.,
Day R. O.
Publication year - 2012
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/j.1463-1326.2012.01617.x
Subject(s) - metformin , medicine , lactic acidosis , renal function , kidney disease , creatinine , endocrinology , gastroenterology , urology , diabetes mellitus , pharmacology
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.