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Metformin Protects Kidney Function Better than Sulphonylurea

Metformin is more protective of the kidneys than sulphonylurea or sulphonylurea plus metformin among patients with diabetes, researchers said….

Adriana Hung, MD, Vanderbilt University, Nashville, Tennessee, stated that, “We think this has to do with 2 pathways.” “Metformin does not cause weight gain, and it has antioxidant and anti-inflammatory properties. We believe metabolic derangement — such as inflammation and oxidative stress — has to do with kidney damage.”

While metformin was found to be the preferable form of therapy, it is not recommended for patients with heart failure, Dr. Hung added. 

Not all patients with diabetes will necessarily develop end-stage renal disease and lose their kidneys, according to Dr. Hung. “What we do early in diabetes is very important to what happens far down the road.”

For the study, Dr. Hung and colleagues reviewed data from 10,418 patients who received oral antidiabetic drugs through the Veterans Administration throughout 2000 to 2007. Patients were divided into 3 groups — patients taking metformin, patients taking sulphonylurea, and patients taking a combination of both drugs.

For each patient, time was measured until consistent decline in estimated glomerular filtration rate, end-stage renal disease, or death.

“Our study design allowed a very long follow-up, sometimes for as long as 7 years,” explained Dr. Hung.

Patients on sulphonylurea had a 1.23 greater likelihood of experiencing 1 of the 3 negative endpoints than those on metformin, and, for the 7,110 patients in whom proteinuria data were available, the risk was 1.32-times greater, the study concluded.

Presented at the American Society of Nephrology (ASN) Nov. 2010:  title: Comparative Effectiveness of Oral Antidiabetic Drugs (OADs) on Kidney Function in Veterans with Type 2 Diabetes. Abstract TH-PO121]