Javaslat a metformin idült vesebetegségben történo alkalmazásának módosítására

Translated title of the contribution: Proposal for the administration of metformin in patients with chronic kidney disease

Zoltán Balogh, J. Mátyus

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Metformin is the first-line, widely used oral antidiabetic agent for the management of type 2 diabetes. There is increasing evidence that metformin use results in a reduction in cardiovascular morbidity and mortality, and might have anticancer activity. An extremely rare, but potentially life-threatening adverse effect of metformin is lactic acidosis, therefore, its use is traditionally contraindicated if the glomerular filtrate rate is below 60 mL/min. However, lactic acidosis is always associated with acute events, such as hypovolemia, acute cardiorespiratory illness, severe sepsis and acute renal or hepatic failure. Furthermore, administration of insulins and conventional antihyperglycemic agents increases the risk of severe hypoglycemic events when renal function is reduced. Therefore, the magnitude of the benefit of metformin use would outweigh potential risk of lactic acidosis in moderate chronic renal disease. After reviewing the literature, the authors give a proposal for the administration of metformin, according to the calculated glomerular filtrate rate. Orv.Hetil., 2012, 153, 1527-1535.

Original languageHungarian
Pages (from-to)1527-1535
Number of pages9
JournalOrvosi Hetilap
Volume153
Issue number39
DOIs
Publication statusPublished - Sep 1 2012

Fingerprint

Metformin
Chronic Renal Insufficiency
Lactic Acidosis
Hypoglycemic Agents
Insulins
Hypovolemia
Acute Liver Failure
Acute Kidney Injury
Type 2 Diabetes Mellitus
Sepsis
Morbidity
Kidney
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Javaslat a metformin idült vesebetegségben történo alkalmazásának módosítására. / Balogh, Zoltán; Mátyus, J.

In: Orvosi Hetilap, Vol. 153, No. 39, 01.09.2012, p. 1527-1535.

Research output: Contribution to journalArticle

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AB - Metformin is the first-line, widely used oral antidiabetic agent for the management of type 2 diabetes. There is increasing evidence that metformin use results in a reduction in cardiovascular morbidity and mortality, and might have anticancer activity. An extremely rare, but potentially life-threatening adverse effect of metformin is lactic acidosis, therefore, its use is traditionally contraindicated if the glomerular filtrate rate is below 60 mL/min. However, lactic acidosis is always associated with acute events, such as hypovolemia, acute cardiorespiratory illness, severe sepsis and acute renal or hepatic failure. Furthermore, administration of insulins and conventional antihyperglycemic agents increases the risk of severe hypoglycemic events when renal function is reduced. Therefore, the magnitude of the benefit of metformin use would outweigh potential risk of lactic acidosis in moderate chronic renal disease. After reviewing the literature, the authors give a proposal for the administration of metformin, according to the calculated glomerular filtrate rate. Orv.Hetil., 2012, 153, 1527-1535.

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