Evre 4 ve 5 Kronik Böbrek Hastaları Metformin Kullanmamalı mı?

Muhammed Çiftçioğlu

doi:10.17517/ksutfd.1181458

EN TR

Shouldn’t Stage 4 And 5 Chronic Kidney Disease Patients Use Metformin?

Öz

Metformin is the first place anti-diabetic agent recommended with life style changes in many guidelines for the treatment of patients with type 2 diabetes mellitus (DM). The mechanism of effect of the drug is to increase insulin sensitivity in peripheral tissue and reduce glucose secretion from the liver. Metformin is a low cost, effective and safe drug. Although its frequent side effects are gastrointestinal side effects and the most feared side effect is lactic acidosis. Due to this side effect, its use is limited in many guidelines in patients with chronic kidney disease (CKD). In this article, we examined the use of metformin in all stages of CKD. We investigated the incidence of metformin-associated lactic acidosis (MALA). Shouldn’t stage 4 and 5 chronic kidney disease patients use metformin? We sought an answer to question. As a result, we decided that side effects like MALA are extremely rare. We observed that these side effects occur mostly in the presence of diseases in which tissue perfusion is impaired such as infections, serious cardiovascular events, and hypotension. Therefore we concluded that the use of metformin may contraindicated in cases where the clinical condition of the patient is unstable rather than side effects such as MALA and especially in stage 5 patients due to the increased risk of accumulation of the drug.

Anahtar Kelimeler

Metformin, Chronic kidney disease, Metformin-associated lactic acidosis

Evre 4 ve 5 Kronik Böbrek Hastaları Metformin Kullanmamalı mı?

Öz

Metformin tip 2 diyabetes mellitus (DM) tanılı hastaların tedavisi için birçok kılavuzda yaşam tarzı değişikliği ile birlikte ilk sırada önerilen anti diyabetik ajandır. İlacın etki mekanizması periferik dokuda insülin duyarlılığını arttırması ve karaciğerden glukoz salınımını azaltmasıdır. Metformin düşük maliyetli, etkin ve güvenilir bir ilaçtır. Sık yan etkisi gastrointestinal yan etkiler olması yanında en korkulan yan etkisi laktik asidozdur. Bu yan etkisi nedeniyle kronik böbrek hastalığı (KBH) tanılı hastalarda birçok klavuzda kullanımı sınırlandırılmıştır. Biz bu yazıda KBH’nin her evresinde metformin kullanımını inceledik. Metfomin ilişkili laktik asidoz (MALA) gelişim sıklığını araştırdık. Evre 4 ve evre 5 KBH hastaları metformin kullanmamalı mı? Sorusuna cevap aradık. Sonuç olarak MALA gibi yan etkilerin son derece nadir olduğuna karar verdik. Bu yan etkilerin daha çok enfeksiyon, ciddi kardiyovasküler olay, hipotansiyon gibi doku perfüzyonunun bozulduğu hastalıklar varlığında ortaya çıktığını gözlemledik. Dolayısıyla metformin kullanımının MALA gibi yan etkilerden ziyade hastanın klinik durumunun stabil olmadığı durumlarda ve ilacın artmış birikim riski nedeniyle özellikle evre 5 hastalarda kontrendike olabileceği kanaatine vardık.vre 4 ve evre 5 KBY’li hastalarda çok da korkmadan kar zarar ilişkisi göz önünde bulundurularak kullanılması gerekliliği kanaatine vardık.

Anahtar Kelimeler

Metformin, Kronik böbrek hastalığı, Metformin ilişkili laktik asidoz

Kaynakça

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Ayrıntılar

Birincil Dil

Türkçe

Konular

Sağlık Kurumları Yönetimi

Bölüm

Derleme

Yazarlar

Muhammed Çiftçioğlu ^*
0000-0002-8017-6502
Türkiye

Erken Görünüm Tarihi

10 Temmuz 2023

Yayımlanma Tarihi

12 Temmuz 2023

Gönderilme Tarihi

28 Eylül 2022

Kabul Tarihi

21 Ekim 2022

Yayımlandığı Sayı

Yıl 2023 Cilt: 18 Sayı: 2

DOI

https://doi.org/10.17517/ksutfd.1181458

IZ

https://izlik.org/JA82PH48PH

APA

Çiftçioğlu, M. (2023). Evre 4 ve 5 Kronik Böbrek Hastaları Metformin Kullanmamalı mı? Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi, 18(2), 126-132. https://doi.org/10.17517/ksutfd.1181458

AMA

1.Çiftçioğlu M. Evre 4 ve 5 Kronik Böbrek Hastaları Metformin Kullanmamalı mı? KSÜ Tıp Fak Der. 2023;18(2):126-132. doi:10.17517/ksutfd.1181458

Chicago

Çiftçioğlu, Muhammed. 2023. “Evre 4 ve 5 Kronik Böbrek Hastaları Metformin Kullanmamalı mı?”. Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi 18 (2): 126-32. https://doi.org/10.17517/ksutfd.1181458.

EndNote

Çiftçioğlu M (01 Temmuz 2023) Evre 4 ve 5 Kronik Böbrek Hastaları Metformin Kullanmamalı mı? Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi 18 2 126–132.

IEEE

[1]M. Çiftçioğlu, “Evre 4 ve 5 Kronik Böbrek Hastaları Metformin Kullanmamalı mı?”, KSÜ Tıp Fak Der, c. 18, sy 2, ss. 126–132, Tem. 2023, doi: 10.17517/ksutfd.1181458.

ISNAD

Çiftçioğlu, Muhammed. “Evre 4 ve 5 Kronik Böbrek Hastaları Metformin Kullanmamalı mı?”. Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi 18/2 (01 Temmuz 2023): 126-132. https://doi.org/10.17517/ksutfd.1181458.

JAMA

1.Çiftçioğlu M. Evre 4 ve 5 Kronik Böbrek Hastaları Metformin Kullanmamalı mı? KSÜ Tıp Fak Der. 2023;18:126–132.

MLA

Çiftçioğlu, Muhammed. “Evre 4 ve 5 Kronik Böbrek Hastaları Metformin Kullanmamalı mı?”. Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi, c. 18, sy 2, Temmuz 2023, ss. 126-32, doi:10.17517/ksutfd.1181458.

Vancouver

1.Muhammed Çiftçioğlu. Evre 4 ve 5 Kronik Böbrek Hastaları Metformin Kullanmamalı mı? KSÜ Tıp Fak Der. 01 Temmuz 2023;18(2):126-32. doi:10.17517/ksutfd.1181458

Shouldn’t Stage 4 And 5 Chronic Kidney Disease Patients Use Metformin?

Öz

Anahtar Kelimeler

Evre 4 ve 5 Kronik Böbrek Hastaları Metformin Kullanmamalı mı?

Öz

Anahtar Kelimeler

Kaynakça

Ayrıntılar

Birincil Dil

Konular

Bölüm

Yazarlar

Erken Görünüm Tarihi

Yayımlanma Tarihi

Gönderilme Tarihi

Kabul Tarihi

Yayımlandığı Sayı

DOI

IZ

Kaynak Göster