- Metformin is not associated with an increased risk for contrast-induced nephropathy (CIN) or metabolic acidosis in patients with type 2 diabetes (T2D) and mild-moderate chronic kidney disease (CKD) undergoing CT scans.
Why this matters
- Findings support 2018 recommendations from the American College of Radiology (ACR), which advises that it is not necessary to discontinue metformin before/after administration of iodinated contrast media in patients with estimated glomerular filtration rate (eGFR, in mL/minute/1.73 m2) ≥30 in the absence of acute kidney injury.
- However, metformin prescribing information recommends stopping metformin at or before an iodinated contrast imaging procedure in patients with eGFR of 30-60.
- 374 Korean patients with mild-moderate diabetic CKD (eGFR, 30-59) undergoing contrast CT (metformin, 42%; other antihypoglycemic agents [OHAs], 58%).
- Funding: Institute of Health Sciences, Biomedical Research Institute Fund.
- Patients receiving metformin vs other OHAs had higher median baseline eGFR (48.6 vs 44.3) and lower mean serum albumin (3.7±0.6 vs 3.5±0.7 g/dL).
- Results showed similar rates of:
- CIN (5.1% vs 10.1%; P=.085).
- Metabolic acidosis (58% vs 65%; P=.195).
- No relationship between CIN and postcontrast metabolic acidosis (P=.434).
- Acidosis risk factors included malignancy (P=.022), low baseline serum albumin (P=.011), and low baseline serum total CO2 (P<.001>
- Retrospective design.