Standard metformin practice is:
GFR 45+. No changes
GfR 30-45. Decrease dose
(but don’t initiate new therapy)
GFR <30. Discontinue
But maybe some low risk patients with CKD IV are losing a benefit by discontinuing their metformin?
GFR 45+. No changes
GfR 30-45. Decrease dose
(but don’t initiate new therapy)
GFR <30. Discontinue
But maybe some low risk patients with CKD IV are losing a benefit by discontinuing their metformin?
Reposted from
Stephen Jenkins
We often stop metformin when eGFR < 30 (CKD stage 4). In this observational study of 4,278 patients with type 2 diabetes and CKD stage 4, stopping metformin (40.1% of patients) was associated with lower 3-year survival (63.7% vs 70.5%). Time for an RCT? #MedSky #NephSky www.ajkd.org/article/S027...
Comments
I can only remember seeing one proper MALA but my goodness they were v v v sick with it…
Let’s stop the metformin and get them on proper doses of SGLT2i and GLP1 RA
Well metformin was discovered first, so…