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Chronic Kidney Disease (CKD) is a progressive condition that affects millions of people around the world. As the kidneys gradually lose their ability to function effectively, managing CKD involves careful attention to diet, lifestyle, and medication.
One medication that comes up for CKD patients is metformin. While metformin is typically used to treat people with type 2 diabetes, it has proved to be beneficial for some people managing CKD. In this blog post, we’ll explore the relationship between metformin and chronic kidney disease, including its benefits, risks, and recommendations for use. As a reminder, please consult your doctor before starting any new medications.
What is metformin?
Metformin is a commonly prescribed medication for managing type 2 diabetes. It helps lower blood sugar levels by improving how the body responds to insulin and reduces the amount of glucose produced by the liver. It's known for its efficacy and low risk of causing low blood sugar. However, its use in patients with CKD requires careful consideration.
How does metformin impact kidney function?
When kidney function is reduced (which happens in CKD), the body may not clear metformin as effectively, potentially leading to a buildup that can be risky.
While it's rare, it can cause lactic acidosis, a serious condition that can happen when lactic acid accumulates in the bloodstream. That's why speaking with your doctor and regularly checking your kidney function is crucial.
What are the guidelines?
Know your eGFR: The estimated glomerular filtration rate (eGFR) measures kidney function.
- eGFR ≥ 45 mL/min: Metformin is usually safe.
- eGFR 30-44 mL/min: You can still use metformin, but it’s wise to be cautious and possibly adjust the dose.
- eGFR < 30 mL/min: It’s best to avoid metformin due to a higher risk of lactic acidosis.
If you’re taking metformin and have CKD, keeping an eye on your kidney function regularly is a great idea. Everyone’s health journey is unique, so your doctor will work with you to consider your overall well-being and any other conditions you may have when deciding if metformin is the right fit for you.
Risks and considerations
While metformin can help lower blood sugar levels, there are some things to keep in mind:
- Lactic Acidosis: This is the most significant concern. It’s rare, but symptoms include weakness, fatigue, and rapid breathing. If you notice any of these, contact your healthcare provider right away.
- Gastrointestinal side effects: Some people experience nausea or diarrhea when starting metformin, which can be uncomfortable but typically improves.
Benefits of metformin with CKD
While there are some considerations to keep in mind with metformin, it's also important to highlight the benefits it can offer for people living with CKD.
- Better blood sugar control: Metformin helps check your blood sugar levels, which is crucial for preventing further kidney damage.
- Heart health: Some research suggests that metformin may lower the risk of heart issues, which is especially important for those with CKD.
- Weight management: Unlike other diabetes medications, metformin is often weight-neutral or may even help with weight loss—a bonus!
The importance of advocacy
Metformin can be a fantastic choice for managing diabetes, even for those with chronic kidney disease, when used properly. Staying on top of regular check-ups and maintaining open communication with your healthcare team is essential to ensuring the best possible balance for your health. Together, you can make informed decisions that support your well-being!
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