Metformin therapy in patients with chronic kidney disease
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.
|ISBN||1463-1326 (Electronic) 1462-8902 (Linking)|
|Authors||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.;|
|Publisher Name||DIABETES OBESITY & METABOLISM|
|URL link to publisher's version||http://www.ncbi.nlm.nih.gov/pubmed/22564555|
|OpenAccess link to author's accepted manuscript version||https://publications.gimr.garvan.org.au/open-access/11555|