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