醫學期刊：Metformin use and mortality in patients with advanced chronic kidney disease: national, retrospective, observational, cohort study
http://www.thelancet.com/journals/landia/article/PIIS2213-8587%2815%2900123-0/abstractTaiwan's NHI research database (2000/1/1 - 2009/6/30), follow-up until 2009/12/31.
12350 T2DM p't with Cr >= 6 mg/dL, 1005 used metformin and 11345 were non-users.
813 metformin users were matched by propensity score to 2439 non-users.
Median follow-up was 2·1 years (range 0·3–9·8)
All-cause mortality was reported in 434 (53%) of 813 metformin users and in 1012 (41%) of 2439 non-users. After multivariate adjustment, metformin use was an independent risk factor for mortality (adjusted hazard ratio 1·35, 95% CI 1·20–1·51; p<0·0001).
Use of metformin in people with type 2 diabetes and a serum creatinine concentration greater than 6 mg/dL is associated with a significantly increased risk of all-cause mortality compared with non-users. Metformin use should not be encouraged in this patient group.
鄭注：Metformin是降血糖第一線用藥，不適合末期腎臟病患者使用，糖尿病患者應定期檢查腎功能（至少每年一次，異常者每三個月一次）。
有抽血檢查腎功能（肌酸酐），可是不知道自己屬於哪一期腎臟病？請到以下網頁計算【腎病指標eGFR】：
http://CKD.notlong.com
【發布日期：2015-04-15】
http://goo.gl/mX8nxo
(一)單方製劑應修訂仿單「禁忌症」處：「腎絲球體過濾率（eGFR）小於30 ml/min/1.73 m2禁用」。
(二)單方製劑應增列「腎絲球體過濾率（eGFR）介於30-45 ml/min/1.73 m2應減量使用」。
(三)含metformin成分複方製劑藥品，若欲修訂腎功能不全患者之禁忌及用法用量，須檢附安全性再評估資料辦理變更登記相關事宜。
