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Metformin in patients with chronic kidney disease and cardiovascular disease


Authors: Vladimír Uličiansky 1;  Zbynek Schroner 2
Authors‘ workplace: Via medica, s. r. o., Košice 1;  SchronerMed, s. r. o., Košice 2
Published in: Diab Obez 2019; 19(37): 45-53
Category: Pharmacotherapy

Overview

Metformin is the first-line pharmacologic treatment for type 2 diabetes. Provided that the dose is adjusted for renal function, metformin treatment appears to be safe and still pharmacologically efficacious in moderate-to-severe chronic kidney disease. According to consensus report by ADA EASD 2018 advantages of metformin include its high efficacy, low cost, minimal hypoglycaemia risk when used as monotherapy, and the potential for some weight loss. UKPDS study have suggested a benefit for preventing cardiovascular disease. Metformin may lower risk for cardiovascular mortality compared with sulfonylurea therapy. Rare cases of lactic acidosis have been reported, usually in the setting of severe illness or acute kidney injury.

Received 13. 4. 2019

Accepted 10. 5. 2019

Keywords:

treatment – continuous glucose monitoring – cardiovascular disease – guidelines


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