A SECONDARY ANALYSIS OF THE CKD-FIX STUDY ANALYSING THE ASSOCIATION BETWEEN METFORMIN USE AND EGFR DECLINE
Isabelle Kitty Stanley1, Andrea Viecelli1,2, David Johnson1,2, Carmel Hawley1,2, Andrew Mallett1,3, Christine Staatz4, Elasma Milanzi5 1The University Of Queensland, Faculty of Medicine, Brisbane, Queensland, Australia2Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia3Department of Renal Medicine, Townsville University Hospital, Townsville, Queensland, Australia4The University of Queensland, School of Pharmacy, Brisbane, Queensland, Australia5Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
Abstract
Aim: We aimed to investigate if the eGFR trajectories of patients with type two diabetes mellitus (T2DM) from the CKD-FIX study population who were taking metformin at baseline differed from those not taking the drug.
Background: There are few interventions available to slow the progression of chronic kidney disease. The anti-diabetic medication, metformin, has been theorised to potentially attenuate decline in eGFR. In 2021 the CKD-FIX trial was published; this phase III trial enrolled adult participants with stage 3 or 4 CKD, several whom also had T2DM and were taking metformin.
Methods: Post hoc analysis comparing participants with stage 3 CKD and T2DM who were taking metformin at baseline with those who were not. Linear mixed modelling was used to estimate the slope difference and identify patterns of eGFR decline and biomarkers over the study duration.
Results: 97 participants were included in this analysis, 51 taking metformin at baseline and 46 not. After adjusting for potential confounders through propensity scores, the between group difference of metformin users and non metformin users was non-significant, but numerically slower in those taking metformin by 0.014 mL/min/1.73m² per week (p=0.459, 95%CI -0.051 to 0.023). The unadjusted average eGFR for those on metformin was higher at all time points, being 7.012 mL/min/1.73m² higher at baseline, and the individual trajectories were also more variable.
Conclusions: We did not identify a statistically significant difference in the patters of eGFR decline in participants with CKD stage 3 and T2DM who were taking metformin at baseline and those who were not. Although this was a relatively small sample size, and due to its nature as a post hoc analysis was subject to confounding factors.
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