Diabetes mellitus: Complex interplay between metformin, AKI and lactic acidosis

Nat Rev Nephrol. 2017 Sep;13(9):521-522. doi: 10.1038/nrneph.2017.105. Epub 2017 Jul 24.


Debate exists regarding the safety of metformin and the risk of metformin-associated lactic acidosis, particularly in the setting of kidney dysfunction. Data from two studies examining the interplay between metformin, acute kidney injury, and complications including lactic acidosis suggest that metformin should be used conservatively in patients with kidney dysfunction.

Publication types

  • News

MeSH terms

  • Acidosis, Lactic / chemically induced*
  • Acute Kidney Injury / chemically induced*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Humans
  • Hypoglycemic Agents / adverse effects*
  • Hypoglycemic Agents / therapeutic use
  • Metformin / adverse effects*
  • Metformin / therapeutic use


  • Hypoglycemic Agents
  • Metformin