Is metformin nephrotoxic?

Is metformin nephrotoxic?

Metformin itself is not a nephrotoxic drug. Initially appointed as the safest hypoglycemic agent in chronic kidney disease, its use has been limited in these patients because of the perceived risk of lactic acidosis.

What medications are nephrotoxic?

Drugs Associated with Nephrotoxicity

Drug class/drug(s) Pathophysiologic mechanism of renal injury
Cisplatin (Platinol) Chronic interstitial nephritis, tubular cell toxicity
Interferon-alfa (Intron A) Glomerulonephritis
Methotrexate Crystal nephropathy
Mitomycin-C (Mutamycin) Thrombotic microangiopathy

Which diabetic drugs are renal protective?


  • Antidiabetes therapy: Current options. Traditionally, insulin has been considered the safe choice for treating diabetic patients with kidney injury.
  • Biguanide – Metformin.
  • Sulfonylureas.
  • Glinides.
  • Alpha-glucosidase inhibitors.
  • Glitazones.
  • Dipeptidyl peptidase-4 inhibitors.
  • Incretin mimetics.

What is a diabetes medication that should not be used by patients with poor kidney function?

Glyburide use should be avoided in patients with severe kidney impairment as defined by a GFR of less than 60 mL/min (CKD stage 3 and below). Because 50 percent of the glyburide is excreted by the kidneys, the drug can build up in people with CKD, causing low blood sugar levels.

Is Lipitor nephrotoxic?

[8] The nephrotoxicity associated with statin was dose dependent and was seen in all statins. Though rosuvastatin is more potent and has a longer half-life, there is no evidence to suggest that rosuvastatin is more nephrotoxic than atorvastatin.

Is nitrofurantoin nephrotoxic?

As renal function deteriorates, the nitrofurantoin bladder concentration decreases and plasma levels increase. Therefore, in renal impairment efficacy is reduced and the potential for adverse reactions increased. Nitrofurantoin is consequently contraindicated in patients with creatinine clearance less than 60 mL/min1.

Which antibiotic is most nephrotoxic?

The potentially nephrotoxic antibiotics in current clinical use are neomycin, kanamycin, paromomycin, bacitracin, the polymyxins (polymyxin B, and colistin), and amphotericin B.

Is linagliptin safe in renal failure?

Therefore, it can be used in normal kidney function as well as in all stages of chronic kidney disease to stage 5 (glomerular filtration rate <15 ml/min/1.73 m2) without dose adjustments. Linagliptin was noninferior to metformin and sulfonylureas in clinical studies.

Is metformin safe with CKD?

So, not only does metformin appear to be safe for people with diabetes and moderate CKD, but it appears to improve health and survival compared to alternative treatments.

Is atorvastatin safe for kidney?

In conclusion, our analysis shows that atorvastatin improves kidney function over time in a dose‐dependent manner (ie, 80‐mg versus 10‐mg dose). In each of the treatment groups it was shown that kidney function improvement is strongly associated with lower cardiovascular risk.

What are nephrotoxic drugs?

Numerous drugs used to manage and treat multiple diseases, including hypertension, diabetes, and other pathologies, are nephrotoxic. These agents are in various classes and categories of medication. This activity reviews the indications, action, and contraindications for nephrotoxic drugs as a valuable agent in choosing key treatment strategies.

How common is drug-induced nephrotoxicity?

Abstract. Drug-induced nephrotoxicity tends to occur more frequently in patients with intravascular volume depletion, diabetes, congestive heart failure, chronic kidney disease, and sepsis. Therefore, early detection of drugs adverse effects is important to prevent progression to end-stage renal disease.

How can drug-induced nephrotoxicity be prevented?

Drug-induced nephrotoxicity tends to be more common among certain patients and in specific clinical situations. Therefore, successful prevention requires knowledge of pathogenic mechanisms of renal injury, patient-related risk factors, drug-related risk factors, and preemptive measures, coupled with vigilance and early intervention.

What is the EGFR of nephrotoxic drugs?

Reports of acute and chronic kidney diseases are increasing in the U.S. and various parts of the world. When looking for a critical metric to understand when not to treat using a nephrotoxic medication, the standard is set at an eGFR less than 60 mL/min per 1.73 m^2.