Nikhil Prasad Fact checked by:Thailand Medical News Team Jan 20, 2025 6 hours, 56 minutes ago
Medical News: Metformin, a medication widely recognized for its efficacy in managing type 2 diabetes mellitus (T2DM), has long been celebrated for its safety, affordability, and cardiovascular benefits. Recently, a groundbreaking study examined whether metformin could also serve as a preventive agent against new-onset chronic kidney disease (CKD) in individuals with T2DM and initially normal kidney function. The research, spearheaded by experts from institutions including the National Cheng Kung University in Taiwan and E-DA Hospital, Kaohsiung, is a critical step in understanding the broader implications of metformin beyond glucose control.
Metformin and Its Potential Role in Protecting Kidney Health
A Closer Look at the Study
This
Medical News report details the findings of a multicenter, retrospective cohort study involving 316,693 patients. Researchers aimed to determine whether metformin could effectively prevent CKD, a progressive condition often associated with diabetes. Using a robust methodology, the team employed inverse probability of treatment weighting (IPTW) to compare 9109 metformin users with 1221 nonusers.
The study’s endpoints included a persistent decline in kidney function as indicated by an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m², a urinary albumin-to-creatinine ratio (UACR) of ≥30 mg/g, or a composite outcome indicative of new-onset CKD. The results were striking, highlighting metformin’s potential to protect kidney health in patients with diabetes.
Key Findings and Implications
-Improved eGFR Outcomes
The metformin group demonstrated significantly better renal outcomes. Among metformin users, the hazard ratio (HR) for a sustained eGFR below 60 mL/min/1.73 m² was 0.71 (95% confidence interval [CI], 0.56–0.90). This finding underscores metformin’s protective effect on kidney function, particularly in preventing the early decline often seen in diabetic kidney disease (DKD).
-Lower Incidence of New-Onset CKD
When evaluating the composite endpoint of new-onset CKD, metformin users also fared better. The HR for CKD development in the metformin group was 0.78 (95% CI, 0.65–0.94). This indicates that metformin may delay the progression of kidney damage, a vital benefit for diabetic patients at risk of CKD.
-Proteinuria Findings
Proteinuria, as indicated by a UACR of ≥30 mg/g, is another critical marker of kidney health. While the metformin group did not show a significant reduction in UACR compared to nonusers, the overall renal benefits were evident through other outcomes.
Mechanisms Underpinning Renal Protection
The renoprotective properties of metformin may arise from multiple biological mechanisms. Researchers suggest that metformin activates AMP-activated protein kinase (AMPK), a critical regulator of cellular energy homeostasis. This activation re
duces oxidative stress, inflammation, and fibrosis, all of which contribute to kidney damage. Studies on diabetic animal models also highlight metformin’s ability to inhibit transforming growth factor-beta expression, reduce glomerulosclerosis, and enhance autophagy.
Safety Considerations
Metformin’s use in CKD prevention requires careful monitoring, particularly in individuals with declining renal function. According to current guidelines, patients with an eGFR between 30 and 44 mL/min/1.73 m² should have their metformin dose reduced, while those with an eGFR below 30 mL/min/1.73 m² are advised to discontinue its use. These precautions aim to mitigate the risk of lactic acidosis, a rare but serious complication associated with metformin.
Study Limitations and Strengths
While the study’s findings are promising, several limitations warrant consideration. As an observational study, the research is susceptible to unmeasured confounding factors despite the rigorous IPTW approach.
Additionally, the reliance on administrative claims data introduces the potential for misclassification of diagnoses and outcomes. Nonetheless, the study’s large sample size and robust statistical analyses provide compelling evidence for metformin’s role in CKD prevention.
Conclusions
Metformin emerges from this study not only as a cornerstone therapy for T2DM but also as a potential guardian of kidney health. By delaying renal decline and reducing the risk of CKD onset, metformin offers hope for millions of individuals grappling with diabetes and its complications. These findings highlight the importance of integrating metformin into diabetes management strategies, particularly for patients with normal kidney function. However, clinicians must balance the benefits with safety considerations, ensuring regular monitoring of renal function and appropriate dose adjustments.
The study findings were published in the peer-reviewed journal: Pharmaceuticals.
https://www.mdpi.com/1424-8247/18/1/95
For the latest on Kidney Health, keep on logging to Thailand
Medical News.
Read Also:
https://www.thailandmedical.news/news/metformin-as-a-potential-antiviral
https://www.thailandmedical.news/news/metformin-shows-promise-in-fatty-liver-disease-and-lowering-blood-fat-levels
https://www.thailandmedical.news/news/-metformin-a-surprising-new-hope-for-pancreatic-tumor-treatment
https://www.thailandmedical.news/news/how-sars-cov-2-spike-protein-triggers-neurodegenerative-diseases-and-the-potential-of-metformin-as-a-therapeutic-remedy
https://www.thailandmedical.news/news/metformin-targets-colorectal-cancer-cell-growth-via-mirna-regulation
https://www.thailandmedical.news/news/metformin-shows-potential-as-an-angiogenic-supplemental-adjuvant-for-glioblastoma-treatment
https://www.thailandmedical.news/news/metformin-use-is-linked-to-reduced-risk-of-developing-certain-blood-cancers
https://www.thailandmedical.news/news/metformin-s-impact-on-immune-response-genes-and-gut-microbiota-in-covid-19-patients-with-type-2-diabetes
https://www.thailandmedical.news/news/covid-19-news-weill-cornell-study-finds-that-sars-cov-2-infects-and-triggers-senescence-of-dopamine-neurons-metformin-helps
https://www.thailandmedical.news/news/cancer-news-austrian-study-finds-that-metformin-might-be-useful-for-treatment-of-metastatic-prostate-cancer
https://www.thailandmedical.news/news/drug-news-metformin-the-wonder-drug-now-shown-to-be-able-to-prevent-muscle-atrophy-and-muscular-fibrosis-in-a-randomized-clinical-trial
https://www.thailandmedical.news/news/breaking-news-metformin-shows-remarkable-results-in-reducing-sars-cov-2-viral-loads-in-phase-3-randomized-clinical-trial-conducted-in-america
https://www.thailandmedical.news/news/breaking-u-s-randomized-clinical-trial-findings-published-in-lancet-shows-that-metformin-reduces-risk-of-developing-long-covid-by-40-percent
https://www.thailandmedical.news/news/metformin-and-leucine:-a-novel-anti-aging-tool-combating-muscle-atrophy-and-cellular-senescence
https://www.thailandmedical.news/news/med-news-stanford-study-find-metformin-use-is-associated-with-lower-incidence-of-osteoarthritis
https://www.thailandmedical.news/news/cleveland-clinic-and-northwestern-university-study-shows-that-metformin-could-be-repurposed-to-treat-atrial-fibrillation-findings-relevant-in-covid-se
https://www.thailandmedical.news/news/molecular-mechanisms-of-the-wonder-drug-:-metformin
Share
Tweet
Share
