Stopping Versus Continuing Metformin in Patients With Advanced CKD: A Nationwide Scottish Target Trial Emulation Study
Current guidance recommends against the use of metformin in people with advanced kidney impairment despite a lack of evidence. It is therefore currently unclear how the decision to stop versus continue metformin in patients who reach stage 4 CKD impacts their risk of mortality and cardiovascular events. This study showed that stopping metformin after reaching stage 4 CKD was associated with reduced survival that did not appear to be mediated by an increase in adverse cardiovascular outcomes. These findings may support the continued use of metformin in patients with advanced kidney impairment, but further research is needed to confirm these observations.
Authors
- Helen M. Colhoun (ORCID: https://orcid.org/0000-0002-8345-3288)
- Emilie Lambourg (ORCID: https://orcid.org/0000-0003-2712-177X)
- Edouard L. Fu (ORCID: https://orcid.org/0000-0002-9698-6825)
- Alistair Emslie‐Smith
- Patrick Barry Mark (ORCID: https://orcid.org/0000-0003-3387-2123)
- Christopher H. Grant (ORCID: https://orcid.org/0000-0002-5249-5442)
- Rory J. McCrimmon (ORCID: https://orcid.org/0000-0002-3957-1981)
- Brian McKinstry (ORCID: https://orcid.org/0000-0001-9581-0468)
- John McKnight (ORCID: https://orcid.org/0000-0002-8214-7625)
- Robert S. Lindsay (ORCID: https://orcid.org/0000-0002-9868-5217)
- Sandra MacRury (ORCID: https://orcid.org/0000-0001-7599-1302)
- Stuart J. McGurnaghan (ORCID: https://orcid.org/0000-0002-3292-4633)
- John R. Petrie (ORCID: https://orcid.org/0000-0002-4894-9819)
- Samira Bell (ORCID: https://orcid.org/0000-0001-9100-1575)
- Neeraj Dhaun (ORCID: https://orcid.org/0000-0001-9128-6603)
- Ewan R. Pearson (ORCID: https://orcid.org/0000-0001-9237-8585)
- Bryan R. Conway (ORCID: https://orcid.org/0000-0002-2888-9249)
- Catherine Armstrong
- Donald Pearson
Institutions
- Brigham and Women's Hospital (US)
- Harvard University (US)
- University of Dundee (GB)
- Leiden University Medical Center (NL)
- Genomics (United Kingdom) (GB)
- Institute of Genetics and Cancer (GB)
- University of Glasgow (GB)
- University of Edinburgh (GB)
Publication Details
- Journal
- American Journal of Kidney Diseases
- Published
- 2024-11-07
- DOI
- https://doi.org/10.1053/j.ajkd.2024.08.012
- Citations
- 5
- Primary Topic
- Diabetes Treatment and Management
- Type
- article
- Field-Weighted Citation Impact
- 1.79
Funders
- University of Dundee
- Wellcome Trust