Observational studyBMC nephrology2017
Risk of acute kidney injury and survival in patients treated with Metformin: an observational cohort study.
Observational study in BMC nephrology, 2017. The graph read 2 numbers from its abstract, feeding 2 cells of the map, but none could be read as for or against, so it casts no vote. It also reports an association that does not count as treatment evidence, such as HR 0.81 (0.69 to 0.94) for survival at 28 days. Cited by 36 papers.
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.
Read, but not usablea number the graph found but could not read as for or against
After adjustment for age, sex, diabetes duration, calendar time, number of diabetes drugs and baseline renal function, current metformin use was not associated with AKI incidence, HR 0.94 (95% CI 0.87, 1.02, p = 0.15).
Among those with incident AKI, being on metformin at admission was associated with a higher rate of survival at 28 days (HR 0.81, 95% CI 0.69, 0.94, p = 0.006) even after adjustment for age, sex, pre-admission eGFR, HbA CONCLUSIONS: Contrary to common perceptions, we found no evidence that metformin increases incidence of AKI and was associated with higher 28 day survival following incident AKI.
clause the extractor read what became the number
Where it lands on the map
Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.
What it adds to each cell
For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.
Metformin×kidney outcomes
No readable resultOpen on the map →What to test next →1 readable study in this cell: 0 favour the treatment, 1 find no difference, 0 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
Metformin×all-cause mortality
No readable resultOpen on the map →What to test next →1 readable study in this cell: 0 favour the treatment, 1 find no difference, 0 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
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
36 citing papers in PubMed, 85 citations in OpenAlex.
- Impact of continuation of metformin prior to elective coronary angiography on acute contrast nephropathy in patients with normal or mildly impaired renal functions.Anatolian journal of cardiology · 2017 · on this mapTrial
- Cardiovascular and metabolic effects of metformin in patients with type 1 diabetes (REMOVAL): a double-blind, randomised, placebo-controlled trial.The lancet. Diabetes & endocrinology · 2017Trial
- Metformin in gastrointestinal cancers and inflammatory bowel disease: Unraveling its mechanisms and therapeutic applications.iScience · 2026Review
- Incidence and risk factors of contrast-associated acute kidney injury in patients hospitalised after contrast-enhanced computed tomography in the emergency department.International journal of emergency medicine · 2025Article
- Disease Progression Modeling of Estimated Glomerular Filtration Rate (eGFR): A Pharmacometrics Approach.Journal of diabetes · 2025Article
- Delaying Renal Aging: Metformin Holds Promise as a Potential Treatment.Aging and disease · 2024Review
- Drug-associated kidney injury in children: a disproportionality analysis of the FDA Adverse Event Reporting System.European journal of pediatrics · 2023Article
- Metformin preconditioning protects against myocardial stunning and preserves protein translation in a mouse model of cardiac arrest.Journal of molecular and cellular cardiology plus · 2023Article
- Update on Diabetic Kidney Disease (DKD): Focus on Non-Albuminuric DKD and Cardiovascular Risk.Biomolecules · 2023Review
- Acute Kidney Injury in Hospitalized Patients with COVID-19: Risk Factors and Serum Biomarkers.Biomedicines · 2023Article
- Management of diabesity: Current concepts.World journal of diabetes · 2023Review
- Acute kidney injury in diabetes mellitus: Epidemiology, diagnostic, and therapeutic concepts.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2023Review
- Patient outcomes following AKI and AKD: a population-based cohort study.BMC medicine · 2022Article
- Metformin protects against cardiac and renal damage in diabetic cardiac arrest patients.Resuscitation · 2022Article
- A concealed history behind the disaster: Extremely rare presentations of metformin toxicity in a patient with body dysmorphic disorder.Toxicology reports · 2022Article
- Metformin, chronic nephropathy and lactic acidosis: a multi-faceted issue for the nephrologist.Journal of nephrology · 2021Review
- How to Assess Diabetic Kidney Disease Progression? From Albuminuria to GFR.Journal of clinical medicine · 2021Review
- Is Metformin a Possible Beneficial Treatment for Psoriasis? A Scoping Review.Journal of personalized medicine · 2021Article
- The Current and Potential Therapeutic Use of Metformin-The Good Old Drug.Pharmaceuticals (Basel, Switzerland) · 2021Review
- Improvement Effect of Metformin on Female and Male Reproduction in Endocrine Pathologies and Its Mechanisms.Pharmaceuticals (Basel, Switzerland) · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The marked sentences are the ones the graph read a number from.
backgroundWhether metformin precipitates lactic acidosis in patients with chronic kidney disease (CKD) remains under debate. We examined whether metformin use was associated with an increased risk of acute kidney injury (AKI) as a proxy for lactic acidosis and whether survival among those with AKI varied by metformin exposure.
methodsAll individuals with type 2 diabetes and available prescribing data between 2004 and 2013 in Tayside, Scotland were included. The electronic health record for diabetes which includes issued prescriptions was linked to laboratory biochemistry, hospital admission, death register and Scottish Renal Registry data. AKI events were defined using the Kidney Disease Improving Global Outcomes criteria with a rise in serum creatinine of at least 26.5 μmol/l or a rise of greater than 150% from baseline for all hospital admissions. Cox Regression Analyses were used to examine whether person-time periods in which current metformin exposure occurred were associated with an increased rate of first AKI compared to unexposed periods. Cox regression was also used to compare 28 day survival rates following first AKI events in those exposed to metformin versus those not exposed.
resultsTwenty-five thousand one-hundred fourty-eight patients were included with a total person-time of 126,904 person years. 4944 (19.7%) people had at least one episode of AKI during the study period. There were 32.4 cases of first AKI/1000pyrs in current metformin exposed person-time periods compared to 44.9 cases/1000pyrs in unexposed periods. After adjustment for age, sex, diabetes duration, calendar time, number of diabetes drugs and baseline renal function, current metformin use was not associated with AKI incidence, HR 0.94 (95% CI 0.87, 1.02, p = 0.15). Among those with incident AKI, being on metformin at admission was associated with a higher rate of survival at 28 days (HR 0.81, 95% CI 0.69, 0.94, p = 0.006) even after adjustment for age, sex, pre-admission eGFR, HbA
conclusionsContrary to common perceptions, we found no evidence that metformin increases incidence of AKI and was associated with higher 28 day survival following incident AKI.
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.