Background: Metformin (MET) is approved for treatment of type 2 diabetes (T2D) in patients with chronic kidney disease stage 3 (CKD3); however, data on its glycemic efficacy in CKD3 is lacking.

Methods: This was a retrospective study including 85,997 U.S. veterans with T2D and estimated glomerular filtration rate (eGFR)≥30 ml/min/1.73m2 treated with MET monotherapy with adequate adherence (defined by proportion of days covered ≥80%) between 01/2010 and 08/2018. CKD3 was defined as eGFR 30-59 ml/min/1.73m2. Twelve-month time-averaged A1c changes from baseline were compared in patients without and with CKD3 using univariate and multivariate linear regression analyses adjusted for case-mix.

Results: The mean±SD age for the total cohort was 60.8±9.9 yrs, 95.2% were males, 76.3 and 13.0% were Whites and Blacks, respectively. Average daily mean±SD MET dose was 1341±202 mg. Pre-existing CKD3 was present in 7,566 (9.7%) of individuals. Baseline characteristics by CKD3 status are shown in Table 1. In unadjusted analysis, mean A1c reduction was 0.59±1.0 vs. 0.52±0.9 % in patients without and with CKD3 (p<0.001). The difference in A1C between two groups was lost after adjustments for baseline characteristics and MET dose (p=0.058).

Conclusions: In this large retrospective study, presence of preexisting CKD stage 3 did not affect glycemic efficacy of metformin monotherapy in T2D patients.


E. Gosmanova: None. D.E. Gemoets: None. L.S. Kaminsky: None. C.P. Kovesdy: Consultant; Self; Amgen, AstraZeneca, Bayer AG, Cara Therapeutics, Reata, Takeda Pharmaceutical Company Limited, Tricida. A.R. Gosmanov: None.

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