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Kidney Week

Abstract: TH-PO062

Association of Inpatient Metformin Use After Recovery from AKI with Lactic Acidosis and Mortality in Type 2 Diabetes Mellitus (DM)

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Chen, Huiwen, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Chang, Hsin-Hsiung, Antai Medical Care Corporation Antai Tian-Sheng Memorial Hospital, Pingtung, Taiwan
Background

Acute kidney injury (AKI) in the hospitalized setting is an independent risk factor for mortality. The higher the degree of AKI, the higher the rate of mortality. Metformin is a baseline antiglycemic therapy for patients with type 2 diabetes melitus (T2DM) without other comorbidy. Recent studies have shown that metfomin has pleiotropic effect and has been linked with lower cardiovascular mortality. The use of metfomin in the inpatient setting is controversial. We are exploring if metformin use after AKI recovery is associated lower mortality and higher degree of lactic acidosis.

Methods

This is a retroscpective cohort study employed the Medical Information MART for Intensive Care IV (MIMIC-IV) databse, which was released by the Massachusetts Institute of Technology Laboratory for Computational Physiology The database contained intensive care unit data from a single teriary care hospital from 2008-2019. The propensity-score matching study was conducted to analyze the outcomes for the sensivity analyses.

Results

Only 37 of 922 metformin users and 3747 of 5175 metformin nonusers had lactate level evaluated. The median level (IQR) WAS 1.4 (1.0-1.7) in the metformin user versus 1.4( 1.1-1.8) in non-users with P 0.902. There was no statistical difference in the degree of lactic acidossi s developed between two groups.

Conclusion

Metformin therapy during hospitalization after AKI recovery in patients with T2DM is not associated with increased risk of lactic acidosis. In addition, metformin user after recovery from AKI stage 2 and stage 3 is associated with lower 1- year mortality than the metfomin non-users.