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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+Kidney+J
2017 ; 10
(3
): 301-304
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Changes in metformin use in chronic kidney disease
#MMPMID28616207
Imam TH
Clin Kidney J
2017[Jun]; 10
(3
): 301-304
PMID28616207
show ga
Metformin is one of the oldest and most widely prescribed antidiabetic medicines
worldwide. It is the only such medicine that has shown a reduction of
cardiovascular mortality in diabetes mellitus type 2. Since many diabetic
patients have chronic kidney disease, its use is often curtailed by practitioners
due to fear of lactic acidosis and the US Food and Drug Administration (FDA)
warnings that, until recently, had been in place for decades. Current guidelines,
though somewhat vague regarding dosages, clearly pave the way for spreading the
use of metformin in patients with lower glomerular filtration rates. These
guidelines also suggest moving away from just looking at serum creatinine to
create a cut-off. Metformin's costs are lower, and in many underdeveloped
countries this is the only medicine available for poor patients. More widespread
use of metformin will further help with health care costs, as well as obesity. It
will simplify the use of diabetes mellitus type 2 management with lower
incidences of hypoglycemia. With all the mounting evidence, the FDA is finally
requiring labeling changes regarding recommendations, to allow the use of
metformin in patients with much reduced kidney function.
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