One of the most common medications to treat diabetes, metformin, is usually not recommended with chronic kidney disease (CKD) patients. For years, many in the medical field have believed metformin increased the risk for lactic acidosis, a potentially deadly condition more commonly seen in CKD patients. Moreover, metformin is cleared by the kidneys, which may not be as effective either in CKD patients, leading to worsening lactic acidosis. 

However, there is some newer evidence to suggest metformin may be safe and beneficial in CKD patients. Researchers from Albany Medical College dug deeper and analyzed the success of metformin on CKD stage 3 patients.* 

What They Did

Using the Department of Veterans Affairs patient database, researchers identified 145,980 patients with type 2 diabetes and CKD stage 3 between November 1999 and November 2017. From the data, researchers analyzed whether patients had significantly different experiences and significantly different changes in glycated hemoglobin (HbA1C), a marker used to identify long-term blood sugar control). 

What They Found

Results showed patients were more likely to stop the Metformin or add a second diabetes medication. Researchers did not assess why Metformin was stopped in certain patients but could be related to tolerance, ineffectiveness or other factors. However, the patients who remained on Metformin had similar average HbA1C levels from baseline to 12 months to 24 months compared to those not on Metformin. 

What it Means

Since Metformin had similar success to other diabetes medications, researchers believe it should be a drug therapy option for mild to moderate CKD patients who tolerate it. 

The research team adds, “These results suggest that metformin monotherapy initiation to improve glycemic control in CKD3 is feasible; however, these patients may require closer follow-up to monitor for metformin adherence, side effects, and therapeutic efficacy.”

*Kaltwasser, J. (2021, May 28). Study: Metformin Effective for Many Patients With T2D, Chronic Kidney Disease. AJMC. https://www.ajmc.com/view/study-metformin-effective-for-many-patients-with-t2d-chronic-kidney-disease