Metformin Treatment for Patients with Diabetes and Chronic Kidney Disease: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement
The safety of metformin use for patients with type 2 diabetes mellitus (T2DM) and advanced kidney disease is controversial, and more recent guidelines have suggested that metformin be used cautiously in this group until more definitive evidence concerning its safety is available. The Korean Diabetes...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Diabetes Association
2020-02-01
|
| Series: | Diabetes & Metabolism Journal |
| Subjects: | |
| Online Access: | http://e-dmj.org/upload/pdf/dmj-44-3.pdf |
| _version_ | 1819159472129441792 |
|---|---|
| author | Kyu Yeon Hur Mee Kyoung Kim Seung Hyun Ko Miyeun Han Dong Won Lee Hyuk-Sang Kwon |
| author_facet | Kyu Yeon Hur Mee Kyoung Kim Seung Hyun Ko Miyeun Han Dong Won Lee Hyuk-Sang Kwon |
| author_sort | Kyu Yeon Hur |
| collection | DOAJ |
| description | The safety of metformin use for patients with type 2 diabetes mellitus (T2DM) and advanced kidney disease is controversial, and more recent guidelines have suggested that metformin be used cautiously in this group until more definitive evidence concerning its safety is available. The Korean Diabetes Association and the Korean Society of Nephrology have agreed on consensus statements concerning metformin use for patients with T2DM and renal dysfunction, particularly when these patients undergo imaging studies using iodinated contrast media (ICM). Metformin can be used safely when the estimated glomerular filtration rate (eGFR) is ≥45 mL/min/1.73 m2. If the eGFR is between 30 and 44 mL/min/1.73 m2, metformin treatment should not be started. If metformin is already in use, a daily dose of ≤1,000 mg is recommended. Metformin is contraindicated when the eGFR is <30 mL/min/1.73 m2. Renal function should be evaluated prior to any ICM-related procedures. During procedures involving intravenous administration of ICM, metformin should be discontinued starting the day of the procedures and up to 48 hours post-procedures if the eGFR is <60 mL/min/1.73 m2. |
| first_indexed | 2024-12-22T16:41:05Z |
| format | Article |
| id | doaj.art-22d5f1d7eec142659c2b13f7e3b4ed5d |
| institution | Directory Open Access Journal |
| issn | 2233-6079 2233-6087 |
| language | English |
| last_indexed | 2024-12-22T16:41:05Z |
| publishDate | 2020-02-01 |
| publisher | Korean Diabetes Association |
| record_format | Article |
| series | Diabetes & Metabolism Journal |
| spelling | doaj.art-22d5f1d7eec142659c2b13f7e3b4ed5d2022-12-21T18:19:51ZengKorean Diabetes AssociationDiabetes & Metabolism Journal2233-60792233-60872020-02-0144131010.4093/dmj.2020.0004731Metformin Treatment for Patients with Diabetes and Chronic Kidney Disease: A Korean Diabetes Association and Korean Society of Nephrology Consensus StatementKyu Yeon Hur0Mee Kyoung Kim1Seung Hyun Ko2Miyeun Han3Dong Won Lee4Hyuk-Sang Kwon5Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, .KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, .KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, .KoreaDivision of Nephrology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, .KoreaDivision of Nephrology, Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, .KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, .KoreaThe safety of metformin use for patients with type 2 diabetes mellitus (T2DM) and advanced kidney disease is controversial, and more recent guidelines have suggested that metformin be used cautiously in this group until more definitive evidence concerning its safety is available. The Korean Diabetes Association and the Korean Society of Nephrology have agreed on consensus statements concerning metformin use for patients with T2DM and renal dysfunction, particularly when these patients undergo imaging studies using iodinated contrast media (ICM). Metformin can be used safely when the estimated glomerular filtration rate (eGFR) is ≥45 mL/min/1.73 m2. If the eGFR is between 30 and 44 mL/min/1.73 m2, metformin treatment should not be started. If metformin is already in use, a daily dose of ≤1,000 mg is recommended. Metformin is contraindicated when the eGFR is <30 mL/min/1.73 m2. Renal function should be evaluated prior to any ICM-related procedures. During procedures involving intravenous administration of ICM, metformin should be discontinued starting the day of the procedures and up to 48 hours post-procedures if the eGFR is <60 mL/min/1.73 m2.http://e-dmj.org/upload/pdf/dmj-44-3.pdfcontrast mediadiabetes mellitusmetforminrenal insufficiency |
| spellingShingle | Kyu Yeon Hur Mee Kyoung Kim Seung Hyun Ko Miyeun Han Dong Won Lee Hyuk-Sang Kwon Metformin Treatment for Patients with Diabetes and Chronic Kidney Disease: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement Diabetes & Metabolism Journal contrast media diabetes mellitus metformin renal insufficiency |
| title | Metformin Treatment for Patients with Diabetes and Chronic Kidney Disease: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement |
| title_full | Metformin Treatment for Patients with Diabetes and Chronic Kidney Disease: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement |
| title_fullStr | Metformin Treatment for Patients with Diabetes and Chronic Kidney Disease: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement |
| title_full_unstemmed | Metformin Treatment for Patients with Diabetes and Chronic Kidney Disease: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement |
| title_short | Metformin Treatment for Patients with Diabetes and Chronic Kidney Disease: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement |
| title_sort | metformin treatment for patients with diabetes and chronic kidney disease a korean diabetes association and korean society of nephrology consensus statement |
| topic | contrast media diabetes mellitus metformin renal insufficiency |
| url | http://e-dmj.org/upload/pdf/dmj-44-3.pdf |
| work_keys_str_mv | AT kyuyeonhur metformintreatmentforpatientswithdiabetesandchronickidneydiseaseakoreandiabetesassociationandkoreansocietyofnephrologyconsensusstatement AT meekyoungkim metformintreatmentforpatientswithdiabetesandchronickidneydiseaseakoreandiabetesassociationandkoreansocietyofnephrologyconsensusstatement AT seunghyunko metformintreatmentforpatientswithdiabetesandchronickidneydiseaseakoreandiabetesassociationandkoreansocietyofnephrologyconsensusstatement AT miyeunhan metformintreatmentforpatientswithdiabetesandchronickidneydiseaseakoreandiabetesassociationandkoreansocietyofnephrologyconsensusstatement AT dongwonlee metformintreatmentforpatientswithdiabetesandchronickidneydiseaseakoreandiabetesassociationandkoreansocietyofnephrologyconsensusstatement AT hyuksangkwon metformintreatmentforpatientswithdiabetesandchronickidneydiseaseakoreandiabetesassociationandkoreansocietyofnephrologyconsensusstatement |