Metformin Use in Kidney Transplant Recipients in the United States: An Observational Study

Jenise Stephen, Teresa L. Anderson-Haag, Sally Gustafson, Jon J. Snyder, Bertram L. Kasiske, Ajay K. Israni
2014 American Journal of Nephrology  
Median serum creatinine (mg/dl) levels before the first claim were lower in recipients with metformin claims than in those with non-metformin claims (1.3 [interquartile range 1.0-1.7] vs. 1.6 [1.2-2.5], respectively; p < 0.0001). Metformin was associated with lower adjusted hazards for living donor (0.55, 95% confidence interval 0.38-0.80; p = 0.002) and deceased donor (0.55, 0.44-0.70; p < 0.0001) allograft survival at 3 years posttransplant, and with lower mortality. Conclusions: Despite
more » ... sions: Despite metformin being contraindicated in renal dysfunction, many kidney transplant recipients receive it, and it is not associated with worse patient or allograft survival. Abstract Background/Aims: Although metformin is contraindicated in patients with increased serum creatinine levels ( ≥ 1.5 mg/ dl in men, ≥ 1.4 mg/dl in women) in the United States, its use has not been systematically examined in kidney transplant recipients. We aimed to determine the frequency of metformin use and its associations among kidney transplant recipients, and to assess allograft and patient survival associated with metformin use. Methods: In this retrospective cohort study, we linked Scientific Registry of Transplant Recipients data for all incident kidney transplants 2001-2012 and national pharmacy claims (n = 46,914). We compared recipients having one or more pharmacy claims for a metformincontaining product (n = 4,609) and recipients having one or more claims for a non-metformin glucose-lowering agent (n = 42,305). Results: On average, metformin claims were filled later after transplant and were associated with higher estimated glomerular filtration rates before the first claim.
doi:10.1159/000370034 pmid:25613554 fatcat:hmsnawxn2jbx3f4tjsvweigpii