Abstract

Introduction:Diabetes is the leading cause of CKD , which makes estimation of renal function crucial. Metformin is the only biguanide extensively used these days and has become the first-line oral drug in the type 2 diabetes, however it is considered unsafe in patients with renal insuffiency because of fears about lactic acid accumulation. Because, the kidney excretesmetformin, any degree of kidney dysfunction would increase the level of metformin and subsequent lactic acid production. We evaluated the risk of CKD among adults who were prescribed metformin for NIDDM, using CKD-EPI equation to estimate kidney function and examined who were potentially stopped or inappropriately using metformin. Methods: We conducted a single centered observational analysis of adults age above 18 years who were prescribed with metformin from august 2016-january 2017 at Vedanta hospital, mangalagiri road, Guntur. CKD was defined using National Kidney Foundation- Kidney Disease outcome Quality Initiative Criteria. GFR was calculated using the CKD-Epidemiology(EPI) collaboration equation. Main results: A larger proportion of patients had renal impairment (eGFR 30-59 ml/min/1.73 m2). Only eleven patient in the entire study had severe renal impairment (eGFR < 15 ml/min/1.73 m2). There was a greater proportion of cessation of metformin in patients with eGFR <60 ml/min/1.73 m2. Conclusion: Most patients were found to have renal insufficiency. Patients with severe renal impairment stopped receiving the metformin after eGFR decline. CKD is common in adults prescribed metformin for type 2 diabetes, so medication safety deserves greater consideration.

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