Hospitalization for Lactic Acidosis Among Patients With Reduced Kidney Function Treated With Metformin or Sulfonylureas
| Autor: | Adriana M. Hung, Amber J. Hackstadt, Carlos G. Grijalva, Christianne L. Roumie, Jonathan Chipman, Marie R. Griffin, Patricia Y. Chu, Robert A. Greevy, Tom A. Elasy |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.drug_class Endocrinology Diabetes and Metabolism Renal function 030209 endocrinology & metabolism Gastroenterology Cohort Studies 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus Internal Medicine Medicine Humans Hypoglycemic Agents Diabetic Nephropathies 030212 general & internal medicine Renal Insufficiency Epidemiology/Health Services Research Acidosis Aged Retrospective Studies Veterans Advanced and Specialized Nursing business.industry Hazard ratio Retrospective cohort study Middle Aged medicine.disease Sulfonylurea Metformin United States Hospitalization Sulfonylurea Compounds Diabetes Mellitus Type 2 Lactic acidosis Acidosis Lactic Female medicine.symptom business medicine.drug Glomerular Filtration Rate |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 |
| Popis: | OBJECTIVE To compare the risk of lactic acidosis hospitalization between patients treated with metformin versus sulfonylureas following development of reduced kidney function. RESEARCH DESIGN AND METHODS This retrospective cohort combined data from the National Veterans Health Administration, Medicare, Medicaid, and the National Death Index. New users of metformin or sulfonylureas were followed from development of reduced kidney function (estimated glomerular filtration rate [eGFR] RESULTS The weighted cohort included 24,542 metformin users and 24,662 sulfonylurea users who developed reduced kidney function (median age 70 years, median eGFR 55.8 mL/min/1.73 m2). There were 4.18 (95% CI 3.63, 4.81) vs. 3.69 (3.19, 4.27) lactic acidosis hospitalizations per 1,000 person-years among metformin and sulfonylurea users, respectively (adjusted hazard ratio [aHR] 1.21 [95% CI 0.99, 1.50]). Results were consistent for both primary discharge diagnosis (aHR 1.11 [0.87, 1.44]) and laboratory-confirmed lactic acidosis (1.25 [0.92, 1.70]). CONCLUSIONS Among veterans with diabetes who developed reduced kidney function, occurrence of lactic acidosis hospitalization was uncommon and not statistically different between patients who continued metformin and those patients who continued sulfonylureas. |
| Databáze: | OpenAIRE |
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