Evidence mapPaperPMID 40864338Full record

ArticleClinical and experimental nephrology2026

Biguanides are associated with decreased early mortality and risk of acute kidney injury in hospitalised patients with COVID-19: a nationwide retrospective cohort study in Japan.

Mari Sugimoto, Hiroaki Kikuchi, Eisei Sohara, Koji Mizutani, Kavee Limbutara, Akihiro Hirakawa, Takayasu Mori, Koichiro Susa, Shuichiro Oya, Takefumi Suzuki and 5 more

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Article in Clinical and experimental nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

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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.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Mari SugimotoDepartment of Periodontology, Institutes of Science Tokyo, Tokyo, Japan.
Hiroaki KikuchiDepartment of Nephrology, Institutes of Science Tokyo, Tokyo, Japan. hiroaki.k1114@gmail.com.ORCID http://orcid.org/0000-0001-7722-4131
Eisei SoharaDepartment of Nephrology, Institutes of Science Tokyo, Tokyo, Japan.
Koji MizutaniDepartment of Periodontology, Institutes of Science Tokyo, Tokyo, Japan.
Kavee LimbutaraDivision of Nephrology and Renal Replacement Therapy, Department of Internal Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Akihiro HirakawaDepartment of Clinical Biostatistics, Institutes of Science Tokyo, Tokyo, Japan.
Takayasu MoriDepartment of Nephrology, Institutes of Science Tokyo, Tokyo, Japan.
Koichiro SusaDepartment of Nephrology, Institutes of Science Tokyo, Tokyo, Japan.
Shuichiro OyaDepartment of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Takefumi SuzukiDepartment of Nephrology, Institutes of Science Tokyo, Tokyo, Japan.
Shotaro NaitoDepartment of Nephrology, Institutes of Science Tokyo, Tokyo, Japan.
Soichiro IimoriDepartment of Nephrology, Institutes of Science Tokyo, Tokyo, Japan.
Tatemitsu RaiDepartment of Nephrology and Hypertension, Dokkyo Medical University, Tochigi, Japan.
Kiyohide FushimiDepartment of Health Policy and Informatics, Institutes of Science Tokyo, Tokyo, Japan.
Shinichi UchidaDepartment of Periodontology, Institutes of Science Tokyo, Tokyo, Japan.

Funding

Japan Society for the Promotion of Science 23K19610Japan Society for the Promotion of Science 24K19143
6 · The paper itself

Abstract

backgroundThe most prescribed oral glucose-lowering medication worldwide is biguanide (BG), which shows potential for further therapeutic applications. The coronavirus disease 2019 (COVID-19) pandemic is a global public health emergency. Nevertheless, low-cost treatments against COVID-19 have not been established, with varying morbidity and mortality rates in each country.

methodsFrom the inpatient databases in Japan from September 2021 to March 2023, which includes the era following the development of COVID-19 vaccines, we extracted data from 168,370 patients with COVID-19 aged 20- < 80 years with diabetes mellitus treated with oral antidiabetic agents. The primary and secondary outcomes were 100-day in-hospital mortality and incidence of acute kidney injury (AKI) during hospitalisation, respectively. We compared outcomes in patients who received BG with those who did not using a logistic regression analysis and Cox proportional hazards under both propensity score-unmatched and matched cohorts.

resultsThe incidence of in-hospital death was significantly lower in the BG group (1.18%) compared with the non-BG group (2.41%) (P < 0.001). Similarly, the incidence of AKI during hospitalisation was significantly lower in the BG group (0.66%) compared to the non-BG group (1.12%) (P < 0.001). Kaplan-Meier analysis from the propensity score-matched cohort showed a significantly better survival rate in the BG group (adjusted HR, 0.619; 95% CI, 0.545-0.702; P < 0.001).

conclusionIn patients with COVID-19, oral biguanide use may be associated with reduced in-hospital mortality and AKI risk.

Indexed as

Acute Kidney InjuryBiguanidesCOVID-19COVID-19 Drug TreatmentHypoglycemic AgentsAdultAgedAged, 80 and overFemaleHospitalizationHospital MortalityHumansIncidenceJapanMaleMiddle AgedBiguanidesHypoglycemic AgentsAcute kidney injuryBiguanidesCOVID-19Mortality

Identifiers

PMID40864338
PMCPMC12811280

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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.