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A: In 2016, the FDA relaxed restrictions on metformin use in people with CKD in two ways. First, they included people who had worse kidney function. Second, they moved away from using the serum creatinine blood test as the marker of kidney disease, and they instead used the estimated glomerular filtration rate (eGFR).
2. Can long-term metformin use cause kidney damage? Metformin doesn’t cause kidney damage. But if your kidneys don’t function properly, there’s concern that metformin can build up in your system and cause lactic acidosis. This is a main reason why your prescriber will monitor your kidney function during your metformin treatment.
A recent retrospective study, demonstrated that metformin use in advanced CKD patients, especially those with CKD 3B, decreased the risk of all-cause mortality and incident end-stage renal disease. 10 Additionally, metformin did not increase the risk of LA.
Researchers are now studying metformin as a possible treatment for kidney disease. A 2021 clinical trial showed that metformin was safe and well tolerated (did not cause severe side effects) in participants with autosomal dominant polycystic kidney disease (ADPKD).
Metformin's side effects can include an increased risk of urinary tract infections. If your pee is cloudy or bloody, or if it hurts when you pee, check with your doctor right away.
Metformin doesn’t damage your kidneys, but having kidney problems may raise your risk of serious side effects. When your kidneys aren’t working at full capacity, metformin can build up in your body instead of being cleared out.
In particular, emerging evidence has demonstrated potential protective effects of metformin on acute kidney injury (AKI), CKD, diabetic kidney disease (DKD), autosomal dominant (adult) polycystic kidney disease (ADPKD), lupus nephritis (LN), renal neoplasm, and kidney transplantation [6 – 12].