Metformin Isn't Associated with Acidosis in Diabetic Patients with Moderate Kidney Disease

The FDA recently relaxed restrictions on metformin use in diabetic patients with moderate chronic kidney disease (CKD). However, because of concern about metformin-associated lactic acidosis the FDA recommends that metformin not be initiated in patients with estimated glomerular filtration rates (eGFRs) ≤45 mL/minute/1.73 m² and notes that it is contraindicated in patients with eGFRs <30 mL/minute. In this community-based cohort study, researchers used data from an integrated healthcare system to compare risks for acidosis-related hospitalization with and without metformin use in 75,000 patients (mean age, 60) with type 2 diabetes who were followed for ≈6 years. The study was replicated using a national database of private healthcare system…