102 results
Metformin in Diabetic Kidney Disease
Immediate release:
 • Initial 500 mg or 850 mg once daily
 •
Metformin in Diabetic ... maximum dose eGFR ... recommended dose eGFR ... < 30: Stop metformin ... annually if on metformin
To improve the usefulness of the serum creatinine concentration as a marker of kidney function, prediction
accurately predict GFR ... Renal Disease (MDRD ... However, the MDRD ... Diagnosis #Nephrology #MDRD ... CockcroftGault #EGFR
Metformin 
Current Renal Dose Adjustments due to Risk of Lactic Acidosis 
> 60 No adjustment 
45-60
Metformin Current ... 45-60 Monitor eGFR ... already taking metformin ... /ambcarerx #Metformin
The GFR Clock for Staging CKD

Staging CKD is most frequently done by calculating the estimated glomerular
The GFR Clock for ... function rate (eGFR ... calculating the eGFR ... to remember the eGFR ... #Nephro #CKD #EGFR
Metformin Pharmacology Summary
Mechanisms of Action:
 • Suppresses gluconeogenesis by the liver
 • Increases insulin-mediated glucose utilization
Metformin Pharmacology ... not initiate if eGFR ... not continue if eGFR ... EricsMedicalLectures/ #Metformin
Management of Diabetes Mellitus in Patients With CKD

1. Monitor for changes in BP, serum creatinine, &
FDA recommends, metformin ... T2D, CKD, & an eGFR ... per 1.73 m2 with metformin ... CKD #ADA #KDIGO #eGFR ... #Insulin #metformin
Diabetes Combination Tablets - Estimated A1c Lowering 
Metformin + DPP4 
• Janumet (metformin + sitagliptin) 
•
A1c Lowering Metformin ... DPP4 • Janumet (metformin ... • Jentadueto (metformin ... • Kombiglyze (metformin ... saxagliptin) Metformin
Interpreting Kidney Biomarkers

↑ Creatinine: 
 • AKI, CKD
 • Medications that lead to nephroprotective ↓ in
nephroprotective ↓ in GFR ... hyperthyroidism ↓ eGFR
Table 1. Equations for estimated glomerular filtration rate (eGFR) in adults based on serum creatinine concentration*.
#Diagnosis
filtration rate (eGFR ... Diagnosis #Nephrology #MDRD ... CockcroftGault #EGFR
Renal Failure Prognosis - The eGFR and proteinuria offers a general prognosis as demonstrated in the
Prognosis - The eGFR ... #CKD #EGFR #Proteinuria