June 26, 2014

VU study shows common diabetes drug can slow chronic kidney disease progression

Vanderbilt investigators have demonstrated in two studies that metformin-based treatments delay the onset and progression of chronic kidney disease (CKD) compared with other treatments for diabetes.

Vanderbilt investigators have demonstrated in two studies that metformin-based treatments delay the onset and progression of chronic kidney disease (CKD) compared with other treatments for diabetes.

Metformin is the most commonly used drug to treat diabetes, but there was no evidence demonstrating its effect on kidney disease until now.

“This novel finding is highly important because development of chronic kidney disease greatly increases the risk of cardiovascular events and death for patients with diabetes,” said Adriana Hung, M.D., MPH, assistant professor of Medicine.

Hung presented both papers at the American Society of Nephrology annual meeting.  The first paper was published in Kidney International and the second in Pharmacoepidemiology and Drug Safety.

Patients with CKD have complex metabolic disturbances including insulin resistance and chronic inflammation.  Metformin is one of the few insulin sensitizers in the arsenal of anti-diabetes drugs that also has important anti-inflammatory and anti-oxidant properties.

“It’s a very important paper because it is the first study to report that there is one drug — metformin — for the treatment of diabetes that can prevent or retard the development of kidney disease in people with diabetes,” Hung said.  “People could potentially use metformin in the early stages of kidney disease.”

Co-authors on the manuscript, entitled “Kidney function decline in metformin versus sulfonylurea initiators: assessment of time-dependent contribution of weight, blood pressure, and glycemic control,” are Christianne Roumie, M.D., MPH, Robert Greevy Jr., Ph.D., Xulei Liu, M.D., M.S., Carlos Grijalva, M.D., MPH, Harvey Murff, M.D., MPH, and Marie Griffin, M.D., MPH.

Hung is the recipient of the Ronald D. Mann Best Paper Award for 2013 from Pharmacoepidemiology and Drug Safety and co-sponsor by the International Society of pharmacopeidemiology (ISPE) for this manuscript. The award will be presented at the annual meeting for the ISPE in Tapei, Taiwan, in November.

The research was done as part of the Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) center at Vanderbilt, which was funded by the Agency for Healthcare Research and Quality, for which Griffin was the principal investigator.