Many patients with diabetes there have been concerns about the use of metformin will feel heart kidney injury. Although there are a lot of doctors out of the rumor that metformin renal injury, Xiao Bian also followed with "metformin does not hurt the kidney. But recently there has been a diabetic found a new clue to blocking the small mouth.
He said: "if not what the metformin renal injury, while taking metformin, the doctor always check the renal function?"
Is it really? Check the renal function during metformin do, but it can not be evidence of renal injury, metformin!
We look at the real reason.
Taking metformin period, why should check the renal function?
After oral administration of metformin, absorbed into blood from the small intestine, within 12 hours of the 90% excreted through the kidneys. Metformin does not damage the kidneys, but on normal renal function play a role. When used in the chronic renal dysfunction patients, due to excretion blocked, may accumulate in the body, leading to lactic acidosis.
Therefore, in patients taking metformin before, should check the renal function, after the annual inspection at least two times, in order to clear the renal function is normal, ensure that metformin can be smoothly discharged from the kidney, no accumulation.
The kidney under what circumstances need to stop taking metformin?
Guidelines for the prevention and treatment of type 2 diabetes China recommendations (2013 edition):
Biguanide drug is contraindicated in patients with renal dysfunction: the level of serum creatinine (1.5mg/dl), male >132.6umol/L female >123.8umol/L (1.4mg/dl) or GFR<45ml/min/1.73m -.
The ADA guidelines for the diagnosis and treatment of diabetic nephropathy on the proposal:
Serum creatinine was greater than 133 umol/L (1.5 mg/dL) (male) or 124 umol/L (1.4 mg/dL) (female) disabled patients;
EGFR (estimated glomerular filtration rate) < 30ml/min/1.73m - when disabled.
Oral antidiabetic drugs for chronic kidney disease in patients with type 2 diabetes mellitus principle Chinese expert consensus (2015 update) advice:
Metformin for 3A chronic kidney disease patients reduced, when the GFR<45 mL/min/1.73m facility is not recommended, when GFR<30 mL/min/1.73m - disabled.