Three people (two males), with mean age (range) 65 (4975) years, presented as emergencies with acute renal failure (AKI). They had type 2 diabetes mellitus, with mean duration 7 (212) years. All three were taking anti-hypertensive therapy: two were on ramipril and one on losartan and indapamide. All three were taking metformin with mean daily dose 2.6 (1.73.0) g. All three patients had mild renal impairment (CKD stage 3), but renal function was stable 23 months before presentation with mean blood urea 8.1 (5.69.5) mmol/l, creatinine 118 (108133) μmol/l and e GFR 49 (4359) ml/min per l. They presented with a 1 week history of symptoms including vomiting (2), diarrhoea (2), unsteadiness (3), confusion (1), and falls (2). On admission the mean blood glucose was 8.5 (4.913.0) mmol/l, urea 32 (22 42) mmol/l, and creatinine 763 (652978)μmol/l. In January, the electronic Medicines Compendium (e MC) updated the Summary of Product Characteristics for Glucophage (metformin), approved by the UK Medicines and Healthcare Products Regulatory Agency (MHRA).
Now, let’s have a look at the introduction of the medicine. Metformin is an oral antidiabetic drug and it is the first-line drug of choice for the treatment of type 2 diabetes, in particalar in overweight and obese people and those with normal kidney function. And nowadays, diabetes has became one leading cause of and Kidney Failure. And some patients who taking the medicine may have the question below. If you want to get natural remedies, don’t forget submit your illness condition in the form below and we will reply as within 24 hours. Actually, metformin is usually not the original cause of kidney problems. Metformin is eliminated by the healthy kidneys, however, when a person has poor function, the metformin can build up in the blood until it reached dangerous levels and cause rare but serious condition called lactic acidosis (a dangerous condition with high mortality rate), and then lactic acidosis will affect the chemistry balance of your blood and can lead to kidney failure and other organ failure. Through the above analysis, we can see metformin itself can not induce kidney failure, but its side effect can become a main cause of kidney damage. The appropriate prescribing of many drugs depends on knowledge of the patient's total renal function, which is proportional to their body mass. The Cockcroft-Gault method of calculating creatinine clearance takes into account the patient's weight. The recently introduced estimated glomerular filtration rate, which is now routinely reported with biochemistry test results, is useful for screening for renal disease, but is unsuitable for calculating doses as it does not take into account the patient's size. The list of medications that need dosage adjustment according to renal function is long, but includes commonly prescribed drugs such as antivirals, hypoglycaemic drugs (metformin, sulfonylureas, insulin), spironolactone and allopurinol. The clearance of many drugs and their metabolites depends on adequate renal function. Renal clearance is especially important for some drugs where the gap between efficacy and toxicity is narrow. Doses of these drugs need careful adjustment if they are prescribed for patients with impaired renal function. Some drugs also have the potential to cause renal toxicity.
Adoptable Dogs. Please read How to Adopt for information about fees and what to bring with you to the shelter. Click on a dog’s picture to see more photos, view their age/size/breed information, and learn about their personality. Publications. Published July 1998. Metformin and Fatal Lactic Acidosis. Information on this subject has been updated. Read the most recent information.