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The first-line diabetes drug — safe in early-mid CKD with dose adjustment, stopped at advanced stages due to lactic acidosis risk.
Metformin is safe at eGFR ≥ 45 with usual dosing, requires dose reduction at 30-45, and is generally stopped below 30 due to lactic acidosis risk. It does not cause kidney damage — the concern is accumulation when clearance falls. The Metformin Eligibility tool applies current guidance by eGFR.
Kidney damage caused by diabetes - the leading cause of kidney failure worldwide, driven by hyperfiltration, albuminuria, and progressive scarring.
A calculated value estimating the rate at which kidneys filter blood, used to diagnose and stage chronic kidney disease.
A rare but serious metabolic emergency — the reason metformin is stopped at advanced eGFR.
A diabetes drug (dapagliflozin, empagliflozin) that reduces kidney and heart risk in CKD even without diabetes.
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This content is a general reference, not medical advice, a diagnosis, or a treatment plan. Do not change your diet, fluids, medicines, or dialysis plan without your nephrologist or renal dietitian. Individual recommendations depend on your labs, medications, conditions, and care plan.