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Metformin and kidney function

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Falkirk Bairn

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Type 2
Does Metformin cause a reduction in kidney function? My GP seems to think so.
My latest blood test results were as follows : HbA1c 57 ; eGFR 35.
I have been on Metformin for around two years (1000mg per day + Linagliptin 5mg per day) and my eGFR has gradually decreased during that period.
My GP has referred me to the local Renal Clinic for further investigation.
Hopefully, the consultant will be able to provide a definitive answer on the possible link between Metformin and reduced kidney function. Fraser
 
I dunno - I was led to think that Metformin was sposed to be kidney protective - but as it doesn't affect me personally, I could easily have missed newer info about it.

But the renal clinic will know more obviously - so hopefully won't take too long before you hear from them.
 
I don’t think metformin reduces kidney function that I know of, but more the other way round. If your kidneys aren’t functioning properly then metformin needs to be used with careful monitoring because it can cause a build up of lactic acid if your kidneys can’t clear things out properly
 
Falkirk Bairn said:
Does Metformin cause a reduction in kidney function? My GP seems to think so.
My latest blood test results were as follows : HbA1c 57 ; eGFR 35.
I have been on Metformin for around two years (1000mg per day + Linagliptin 5mg per day) and my eGFR has gradually decreased during that period.
My GP has referred me to the local Renal Clinic for further investigation.
Hopefully, the consultant will be able to provide a definitive answer on the possible link between Metformin and reduced kidney function. Fraser
Click to expand...
My eGFR has improved whilst i have been on Metformin. Not sure if weight reduction and exercise has played a big part in that though.
 
I have chronic kidney disease (ckd) due to Diabetes , some yrs ago I was taken off Metformin because my kidney function had dropped too low to be able to cope with Metformin.

My understanding is , yes in some ways Metformin can protect your kidneys but if your kidney function drops below a certain level It can cause problems. It depends on which stage you are at with your kidney function whether you have to come off it or not.

Don’t worry about the appointment with the renal specialist either , it is not unpleasant at all
Blood test, urine samples a week or two before appointment

Pre Covid this was how my firstRenal appointment went .
Another urine sample, weigh in, bp check. I can’t remember if they took another blood sample
Then you see the doctor who explains everything, including what level your kidney function is at.

Depending on the cause , kidney function can improve.
Mine takes a bit of a dive on some meds or infections but so far fingers crossed mine has gone back up to a safer level later . Hopefully yours will improve too.

Please let us kno how you get on. I know it is scary for you right now , but please try not to panic Ok.
 
Are you on any blood pressure medication? I recently had a bit of a scare when my kidney function (eGFR) dropped to 39. It was caused by a combination of blood pressure medications, Losartan and Amlodipine. When BP meds were adjusted it rose again to 73.
 
Ljc said:
I have chronic kidney disease (ckd) due to Diabetes , some yrs ago I was taken off Metformin because my kidney function had dropped too low to be able to cope with Metformin.

My understanding is , yes in some ways Metformin can protect your kidneys but if your kidney function drops below a certain level It can cause problems. It depends on which stage you are at with your kidney function whether you have to come off it or not.

Don’t worry about the appointment with the renal specialist either , it is not unpleasant at all
Blood test, urine samples a week or two before appointment

Pre Covid this was how my firstRenal appointment went .
Another urine sample, weigh in, bp check. I can’t remember if they took another blood sample
Then you see the doctor who explains everything, including what level your kidney function is at.

Depending on the cause , kidney function can improve.
Mine takes a bit of a dive on some meds or infections but so far fingers crossed mine has gone back up to a safer level later . Hopefully yours will improve too.

Please let us kno how you get on. I know it is scary for you right now , but please try not to panic Ok.
Click to expand...
Hello Ljc,
Thanks for your reply. Very helpful. Interesting to hear you say that kidney function can improve. My own GP doesn't think so. He says it's irreversible! I find that quite worrying. I await with interest my appointment with the renal consultant.
 
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Pattidevans said:
Are you on any blood pressure medication? I recently had a bit of a scare when my kidney function (eGFR) dropped to 39. It was caused by a combination of blood pressure medications, Losartan and Amlodipine. When BP meds were adjusted it rose again to 73.
Click to expand...
Hello Pattidevans,
Many thanks for your reply.
I'm not on any blood pressure medication. My blood pressure has always been fine.
Interesting to hear that your eGFR rose again. According to my GP, reduction in kidney function is irreversible, which I find quite worrying!
I await with interest my consultation at the Renal Clinic.
 
I was told that my reduced kidney function was due to Metformin, and in the last few days my mum has been diagnosed with reduced kidney function and her GP said the same, to the point of stopping her metformin as her blood glucose control is good.
 
Falkirk Bairn said:
Hello Ljc,
Thanks for your reply. Very helpful. Interesting to hear you say that kidney function can improve. My own GP doesn't think so. He says it's irreversible! I find that quite worrying. I await with interest my appointment with the renal consultant.
Click to expand...
It really depends on what is causing the reduced kidney function whether or not they can improve , mine was diabetes related. it was only discovered at my T2 diagnosis. Metformin was fine fir the level my ckd was at at the time . Don’t get me wrong , GPs are generalists , they do know a lot but the specialists know more about their particular field than many GPs can.

Fingers crossed will will soon be able to come here and say phew
 
Ljc said:
It really depends on what is causing the reduced kidney function whether or not they can improve , mine was diabetes related. it was only discovered at my T2 diagnosis. Metformin was fine fir the level my ckd was at at the time . Don’t get me wrong , GPs are generalists , they do know a lot but the specialists know more about their particular field than many GPs can.

Fingers crossed will will soon be able to come here and say phew
Click to expand...
Thanks again for your reply.
My GP says my reduced kidney function is related to my diabetes.
 
Further to my initial message, I have now been informed that I've been referred to a Diabetes Consultant, rather than a Renal Consultant. Should I request to be referred to a Kidney Specialist rather than a Diabetes Consultant? Or will a Diabetes Consultant have sufficient knowledge of reduced kidney function?
 
Falkirk Bairn said:
Further to my initial message, I have now been informed that I've been referred to a Diabetes Consultant, rather than a Renal Consultant. Should I request to be referred to a Kidney Specialist rather than a Diabetes Consultant? Or will a Diabetes Consultant have sufficient knowledge of reduced kidney function?
Click to expand...

I would attend the appointment with the diabetes consultant in the first instance - they should know specifically about kidney health in the context of diabetes, and will be able to refer you on if they think you need any more specific kidney-related care.

Hope you get some reassurance and helpful information.

I have had my microalbuminuria (another marker of kidney health) rise and fall over the years, so I suspect as @Ljc suggests it really depends on what the damage to the kidneys is as to whether or not it is likely to improve?

Good to hear that your BP is usually within the recommended ranges, as this is very helpful to kidney health I think. Keeping your blood glucose levels as stable as you can is good too.
 
Hi . This is just my opinion as I am no medic.
The diabetes Consultant should know an awful lot about how diabetes and the various medications for it can affect your kidneys as well as other organs etc. , they may not know the best medications etc that can help protect your kidneys, but will know how to find out as well as what if any other tests are needed.
They can and will refer refer you to the renal clinic if necessary.

It’s similar for the renal clinic too, as they will be seeing a lot of people who have ckd related to their diabetes.


When my kidney function was found to have dropped too low for Metformin , I was in hospital at the time for another diabetes related problem . My meds were changed again lol. and I was referred to the renal clinic .

My suggestion is to speak to your Gp again and ensure they understand your worries about perhaps not being under the right specialist.

Speaking very personally I would prefer to be under the renal clinic but that is just me.
 
I'd prefer both - and that they communicate TBH ......

I'm living in the past .......
 
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Just to add my own experience...when I asked the DN if I could come off metformin completely due to hba1c of 36, she said she preferred to keep me on one a day as it "helps protect the heart and kidneys". Now I'm completely confused! It's great that you are being sent to the Renal clinic for further investigation from the experts. Best of luck x
 
Vonny said:
Just to add my own experience...when I asked the DN if I could come off metformin completely due to hba1c of 36, she said she preferred to keep me on one a day as it "helps protect the heart and kidneys". Now I'm completely confused! It's great that you are being sent to the Renal clinic for further investigation from the experts. Best of luck x
Click to expand...
Try not to be confuses @Vonny . Some drugs can help protect the kidneys in one way but for some people they adversly affect the kidneys . The renal guy put me Ona low dose Ramipril in the hope they help my kidneys but explained they could affect them, so they needed to keep a closer eye on them fir awhile . it’s the same with Metformin. Good in one way but in some people ..... it also depends on your level of kidney function .
 
Ljc said:
Try not to be confuses @Vonny . Some drugs can help protect the kidneys in one way but for some people the blood affect the kidneys . The renal guy put me Ona low dose Ramipril in the hope they help my kidneys but explained they could affect them, so they needed to keep a closer eye on them fir awhile . it’s the same with Metformin. Good in one way but in some people ..... it also depends on your level of kidney function .
Click to expand...
A bit like the treatment for gout, the therapeutic dose is only just short of the lethal dose. :(
 
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