Kidney function decline in metformin versus sulfonylurea initiators: assessment of time‐dependent contribution of weight, blood pressure, and glycemic control

Hung, Adriana M.; Roumie, Christianne L.; Greevy, Robert A.; Liu, Xulei; Grijalva, Carlos G.; Murff, Harvey J.; Griffin, Marie R.

doi:10.1002/pds.3432

Cited by 41 publications

(43 citation statements)

References 59 publications

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“…Those receiving metformin reported lower risk of kidney disease progression when compared to sulfonylurea. The aforementioned finding was independent of body mass index, systolic blood pressure and glycosylated hemoglobin . A separate study of patients with PCOS also demonstrated no adverse affect on kidney function with metformin …”

mentioning

confidence: 72%

“…We already know that metformin dose reduction and adequate hydration are key components to guard against kidney injury and lactic acidosis in those with kidney disease. The safety of metformin is further exemplified in a study of over 13,000 veterans initiated on either a sulfonylurea or metformin and followed for more than a decade . Those receiving metformin reported lower risk of kidney disease progression when compared to sulfonylurea.…”

mentioning

confidence: 99%

“…这些研究结果是否足以改变临床实践？在我们看来未必。目前我们已经知道，在那些肾病患者中，为了防止肾脏损伤与乳酸性酸中毒，减少二甲双胍的剂量以及充分的饮水非常重要。在一项超过13000名退役军人参与的研究中，二甲双胍的安全性进一步得到了证实，在这项研究中他们使用一种磺脲或者二甲双胍进行起始治疗，随访时间超过了10年。与接受磺脲治疗的患者相比较，接受二甲双胍治疗的患者肾病进展的风险更低。上述的研究结果不依赖于体重指数、收缩压以及糖化血红蛋白。在另外一项PCOS患者的研究中也证实了二甲双胍对肾功能没有不良影响。…”

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Metformin nephrotoxicity insights: Will they change clinical management? (二甲双胍肾毒性的见解：它们会导致临床治疗出现变化吗？)

Thomas

Bakris

2013

Journal of Diabetes

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mentioning

confidence: 72%

mentioning

confidence: 99%

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Metformin nephrotoxicity insights: Will they change clinical management? (二甲双胍肾毒性的见解：它们会导致临床治疗出现变化吗？)

Thomas

Bakris

2013

Journal of Diabetes

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“…44,45 However, it is also important to consider the specific disadvantages of the alternative treatment options. Although the treatment of diabetes is evolving, many agents are contraindicated or unlicensed for use in advanced CKD.…”

Section: Disadvantages Of Other Treatment Optionsmentioning

confidence: 99%

Metformin in advanced chronic kidney disease: are current guidelines overly restrictive?

et al. 2016

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Type 2 diabetes mellitus and chronic kidney disease (CKD) frequently co-exist and the increasing burden of both conditions is a global concern. Metformin is established as the first-line treatment for type 2 diabetes because it is associated with improved cardiovascular outcomes and a reduced risk of hypoglycaemia compared with other treatment options. Patients with CKD may benefit in particular because they are at high risk of both cardiovascular disease and hypoglycaemic episodes. However, the use of metformin is restricted in this population due to the concerns over lactic acidosis. Recent reviews have evaluated this risk and concluded that current guidelines for prescribing metformin in CKD may be too restrictive. This narrative review considers this evidence further, but also examines the strength of evidence that favours the use of metformin in CKD patients. Br J Diabetes 2016;16:168-175

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“…Metformin initiation has been shown to be associated with a lower risk of decline in kidney function or death compared to sulfonylureas independent of changes in body mass index and systolic blood pressure and glycated haemoglobin over time [66]. …”

Section: Renoprotective Effect Of Metformin In Human In Retrospectivementioning

confidence: 99%

Renoprotective Effects of Metformin

Broe

Kajbaf

Lalau

2017

Nephron

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Background/Aims: It has become clear that metformin exerts pleiotropic actions beyond its glucose-lowering agent effect. In this review, we summarise the state of the art concerning the potential renoprotective effects of metformin in vitro, animal models and clinical nephrology. Methods: A literature search was performed in PUBMED, ScienceDirect, between January 1957 and March 2017 using the following keywords: “metformin,” “nephroprotection,” “renoprotection,” “survival,” “renal failure,” “chronic kidney diseases,” “fibrosis,” “polycystic kidney disease” and “microalbuminuria.” Results: A recent review of 17 observational studies concluded that metformin use appeared associated with reduced all-cause mortality in patients with CKD. Metformin has been shown to exert positive effects on the kidney in vitro and animal models representing different types of renal diseases, from acute kidney injury to chronic kidney disease. A retrospective cohort study from the Scientific Registry of Transplant Recipients indicated that metformin was associated with lower adjusted hazards for living donor and deceased donor allograft survival at 3 years posttransplant, and with lower mortality. Conclusion: Based on experimental evidence and some relevant clinical observations, metformin seems to be a promising drug in the treatment of progressive renal damage. RCT studies are the next essential step.

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Kidney function decline in metformin versus sulfonylurea initiators: assessment of time‐dependent contribution of weight, blood pressure, and glycemic control

Cited by 41 publications

References 59 publications

Metformin nephrotoxicity insights: Will they change clinical management? (二甲双胍肾毒性的见解：它们会导致临床治疗出现变化吗？)

Metformin nephrotoxicity insights: Will they change clinical management? (二甲双胍肾毒性的见解：它们会导致临床治疗出现变化吗？)

Metformin in advanced chronic kidney disease: are current guidelines overly restrictive?

Renoprotective Effects of Metformin

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