Kidney Week

Abstract: FR-PO646

Metformin Is Renoprotective Only in Patients with Progressive Renal Function Decline

Session Information

• Diabetic and Obesity Induced Kidney Disease - Clinical - II
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Diabetes

• 502 Diabetes Mellitus and Obesity: Clinical

Author

• Araki, Makoto, Suwa Central Hospital, Nagano-ken, Japan

Makoto Araki,

Background

SGLT2 inhibitors have renoprotective properties. Metformin is a first-line drug for treating diabetes mellitus, but it is unknown if it is renoprotective.

Methods

This was a retrospective observational study. From January 2009 to December 2015, we obtained medical records of patients prescribed metformin at our facility. The medical record sampling began on the day the patient demonstrated eGFR <60 ml/min/1.73m² (hereinafter, omit "ml/min/1.73m²"), and ended on the day when eGFR <45 or <30. Exclusion criteria are as follows: (1) Short-term period between date reached eGFR <60 and the last creatinine (Cr) measurement date, (2) The same day reached eGFR <60 and <45. All patients were divided into two groups depending on whether metformin was prescribed for less than or more than 1 year ("<1 year group" and ">1 year group"). The survival curve for the outcome was illustrated using the Kaplan–Meier method.

Results

Of the 1,334 subjects who received metformin, 691 (51.8%) had recorded eGFR <60 more than once. Overall, 469 subjects meet the criteria (average age 68.5 years, 299 males, eGFR 55.5 ± 3.84, "<1 year group" was 162 people). 222 subjects with eGFR <45 and 66 subjects with eGFR <30 reached the study endpoint. First, we conducted a retrospective cohort study. No between-group differences were found for reaching the study endpoint(Fig1). Next, we conducted a case-control analysis in the people who reached the study endpoint. We found no differences at the endpoint of eGFR <45. But at the endpoint of eGFR <30, “>1 year group” demonstrated slower renal function decline than the “<1 year group” (Fig2. 47 vs 19 subjects; median 1354 vs 830 days, log-rank test p = 0.01). No subjects developed lactic acidosis over the course of the study.

Conclusion

Metformin exhibited a renoprotective effect in patients. However, it was limited to the progressive renal function decline group