Metformin and kidneys

Česká verzia

Authors: A. Šmahelová
Authors place of work: Diabetologické centrum Kliniky gerontologické a metabolické Lékařské fakulty UK a FN Hradec Králové, přednosta prof. MUDr. Luboš Sobotka, CSc.
Published in the journal: Vnitř Lék 2008; 54(5): 535-540
Category:

Summary

Metformin is currently recommended as the first-line drug for type 2 diabetic patients once the disease has been diagnosed. In addition to antihyperglycaemic effect, it has other effects which have a positive effect on cardiovascular risk. The greatest risk of metformin treatment is lactate acidosis, but its incidence is very low if the contraindications are observed. In spite of the fact that not all contraindications are observed in practice, the incidence of lactate acidosis demonstrably provoked by metformin does not grow. In spite of ongoing discussion on the subject, contraindications still include all states involving the risk of lactacidosis including renal insufficiency.

Key words:
metformin – renal function – lactate acidosis – metformin contraindications

Zdroje

1. Calabrese AT, Coley KC et al. Evaluation of prescribing practices: risk of lactic acidosis with metformin therapy. Arch Intern Med 2002; 2: 434-437.

2. Gomes MB, Cailleaux S, Solange C et al. Effects of metformin on endothelial dysfunction of the renal circulation resulting from acute hyperglycemia in non-diabetic rabbits. Arq Bras Endocrinol Metab 2005; 49: 938-994.

3. Holstein A, Stumvoll M. Contraindications can damage your health - is metformin a case in point? Diabetologia 2005; 48: 2454-2459.

4. Charpentier G, Riveline JP, Varroud-Vial M. Management of drugs affecting blood glucose in diabetic patients with renal failure. Diabetes & Metabolism 2000; 26: 73-85.

5. Killop AM, Duffy NA, Lindsay H et al. Decreased dipeptidyl peptidase-IV activity and glucagon-like peptide-1(7-36)amide degradation in type 2 diabetic subjects. Diabetes Res Clin Pract 2007; 273: 157-169.

6. Krentz AJ. Insulin Resistance: a clinical handbook. Osney Mead, Oxford: Blackwell Science a Blackwell Publishing Company 2002.

7. Lebovitz HE. Therapy for Diabetes Mellitus and Related Disorders. 4th ed. Alexandria: American Diabetes Association: 2004.

8. Lindsay JR, Duffy NA, McKillop AM et al. Inhibition of dipeptidyl peptidase IV activity by oral metformin in Type 2 diabetes. Diabet Med 2005; 22: 654-657.

9. Mithieux G, Rajas F, Zitoun C. Glucose utilization is suppressed in the gut of insulin-resistant high fat-fed rats and is restored by metformin. Biochem Pharmacol 2006; 72: 198-203.

10. Orban JC, Giunti C, Levraut J et al. L'acidose lactique reste une complication grave du traitement par metformine = Metformin-associated lactic acidosis remains a serious complication of metformin therapy. Ann Fr Reanim, 2003; 22: 461-465.

11. Rachmani R, Slavachevski I, Levi Z et al. Metformin in patients with type 2 diabetes melllitus: reconsideration of traditional contraindications. Eur J Intern Med 2002; 13: 428-433.

12. Salpeter SR, Greyber E, Pasternak GA et al. Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus: systematic review and meta-analysis. Arch Intern Med 2002; 163: 2594-2602.

13. Stang M, Wysowsk DK, Hitler-Jones D. Incidence of lactic acidosis in metformin users. Diab Care 1999; 22: 925-992.

14. Šmahelová A. Akutní komplikace diabetu. Praha: Triton 2006.

15. Tanihara Y, Masuda S, Katsura H et al. Subtrate specificity of MATE1 and MATE2-K, human multidrug and toxin sextrusions/H(+)-organic antiporters. Biochem Pharmacol 2007; 74: 359-371.