ReviewPeritoneal dialysis international : journal of the International Society for Peritoneal Dialysis2014
Metformin in chronic kidney disease: time for a rethink.
Review in Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Is the use of metformin in patients undergoing dialysis hazardous for life? A systematic review of the safety of metformin in patients undergoing dialysis.British journal of clinical pharmacology · 2019Pooled it
- The Association between Metformin Therapy and Lactic Acidosis.Drug safety · 2019Pooled it
- Endothelial dysfunction in chronic kidney disease: a clinical perspective.American journal of physiology. Heart and circulatory physiology · 2025Review
- The effects of type 1 and type 2 diabetes mellitus on bone health in chronic kidney disease.Nature reviews. Endocrinology · 2025Review
- Functional and Biochemical Analyses of Glycerol Kinase and Glycerol 3-phosphate Dehydrogenase in HEK293 Cells.The protein journal · 2025Article
- Impact of metformin on cardiovascular and kidney outcome based on kidney function status in type 2 diabetic patients: a multicentric, retrospective cohort study.Scientific reports · 2024Observational
- Metformin: A Review of Potential Mechanism and Therapeutic Utility Beyond Diabetes.Drug design, development and therapy · 2023Review
- Metformin as adjunctive therapy in combination with multidrug treatment for multibacillary leprosy: A protocol for a randomized double-blind, controlled Phase 2 trial in Indonesia (MetLep Trial).Wellcome open research · 2023Article
- The Effect and Safety Assessment of Metformin and DLBS3233 (A Bioactive Fraction ofInternational journal of women's health · 2023Article
- The Potential Therapeutic Role of Metformin in Diabetic and Non-Diabetic Bone Impairment.Pharmaceuticals (Basel, Switzerland) · 2022Review
- Antidiabetic effects of betulinic acid mediated by the activation of the AMP-activated protein kinase pathway.PloS one · 2021Article
- Global Epidemiology, Health Outcomes, and Treatment Options for Patients With Type 2 Diabetes and Kidney Failure.Frontiers in clinical diabetes and healthcare · 2021Review
- Article
- Iraqi Experts Consensus on the Management of Type 2 Diabetes/Prediabetes in Adults.Clinical medicine insights. Endocrinology and diabetes · 2020Review
- Risk of Kidney Dysfunction from Polypharmacy among Older Patients: A Nested Case-Control Study of the South Korean Senior Cohort.Scientific reports · 2019Article
- Monitoring Patients on Metformin: Recent Changes and Rationales.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2018Review
- Acute kidney injury, plasma lactate concentrations and lactic acidosis in metformin users: A GoDarts study.Diabetes, obesity & metabolism · 2017Article
- Metformin associated lactic acidosis (MALA): clinical profiling and management.Journal of nephrology · 2016Review
- Pharmacology and therapeutic implications of current drugs for type 2 diabetes mellitus.Nature reviews. Endocrinology · 2016Review
- Metformin and patients on dialysis.Australian prescriber · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Metformin has traditionally been regarded as contraindicated in chronic kidney disease (CKD), though guidelines in recent years have been relaxed to permit therapy if the glomerular filtration rate (GFR) is > 30 mL/min. The main problem is the perceived risk of lactic acidosis (LA). Epidemiological evidence suggests that this fear is disproportionate. Lactic acidosis is a rare complication to type 2 diabetes mellitus (T2DM), with an incidence of 6/100,000 patient-years. The risk is not increased in metformin-treated patients. Metformin possesses a number of clinical effects independent of glucose reduction, including weight loss, which are beneficial to patients. The risk of death and cardiovascular disease is reduced by about a third in non-CKD patients. Since metformin intoxication undoubtedly causes LA, and metformin is renally excreted, inappropriate dosage of metformin will increase the risk of LA. It is suggested that introduction of metformin therapy to more advanced stages of CKD may bring therapeutic benefits that outweigh the possible risks.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.