EIMER MCMULLAN1, SIOBHAN BURKE1, Hemant KULKARNI
1Royal Perth Hospital, Perth, Australia, 2Armadale Health Services, , Australia, 3University of Western Australia, Perth, Australia
Biography:
Bio to come
Background:
Off label use of Metformin in advanced CKD is commonly utilised despite warnings against its use due to its association with lactic acidosis.
Aims:
To explore the safety of Metformin use in patients with Stage V CKD. An assessment of real-life clinical practice.
Methods:
We assessed the current and historical use of Metformin in patients meeting CKD V criteria over a 2-year period (April 2023 to April 2025) within the Armadale catchment Renal Services at East Metro Health Services. The indication, dose, length of treatment during Stage 4 and Stage 5 CKD, and any recorded adverse events in Electronic or Paper Medical Records were analysed in a retrospective study.
Results:
86 eligible subjects were studied. All patients received treatment for Type 2 diabetes. Mean metformin dose was 500mg XR OD in CKD V.
Metformin was tolerated by 77 patients on long term basis. 2 patients had documented Metformin induced Lactic Acidosis (MALA), both with CKD V. In 2/2 patients MALA was related to acute illness (UTI and Enterovirus) and they recovered without any sequelae. These patients were subsequently restarted on metformin with no further issues.
Results:
Incidence of MALA in Stage 5 CKD is marginally elevated than general population. MALA is rare and can be managed with no sequelae. Metformin can be beneficially and safely used in low doses with monitoring. Larger studies are needed to confirm our findings.