Systematic review and meta-analysis of current guidelines, and their evidence base, on risk of renal function after administration of contrast medium for diabetic patients receiving metformin
Abstract
Purpose: Our study aimed to determine through a meta-analysis whether continuing metformin use in diabetic patients receiving contrast agents would increase the risk of renal impairment and metabolic abnormalities.
Methods: We searched the PubMed, EBSCO, Medline, and the Cochrane Central Register of Controlled Trials from the inception dates to March 2024. The included studies comparing metformin users and non-users during contrast agent administration in diabetic patients. Outcome measures included contrast-induced acute kidney injury (CI-AKI), serum creatinine, estimated glomerular filtration rate (eGFR), lactate level, and incidence of metabolic acidosis. We used odds ratio (OR) for dichotomous outcomes and weighted or standardized mean difference (WMD or SMD) for continuous outcomes, depending on scale consistency across studies.
Results: Analysis involved 2 randomized controlled trials and 5 retrospective cohorts comprising 2020 patients. There were no significant differences between the metformin and non-metformin groups in CI-AKI incidence (OR: 0.87, 95% CI: 0.63-1.20), changes in renal function (serum creatinine: SMD: -0.15, 95% CI: -0.64-0.35; eGFR: WMD: 3.35, 95% CI: -1.60-8.29), incidence of metabolic acidosis (OR: 0.90, 95% CI: 0.57-1.43), and lactate levels (SMD: 0.29, 95% CI: -0.53-1.11). Sensitivity analysis excluding one study revealed a significant reduction in creatinine with metformin. Logistic regression meta-analysis showed that metformin use was not…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Metformin as an adjuvant in breast cancer treatment
- Metformin Lysosomal Targeting: A Novel Aspect to Be Investigated for Metformin Repurposing in Neurodegenerative Diseases?
- Aberrant HSF1 signaling activation underlies metformin amelioration of myocardial infarction in mice
- Metformin induces ZFP36 by mTORC1 inhibition in cervical cancer-derived cell lines
- Protein Interaction Network for Identifying Vascular Response of Metformin (Oral Antidiabetic)
- Preventing Long COVID With Metformin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.