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09/17/09 05:14 PM

"Lab results = 39% kidney function. Lisinopril dc'd x 3 weeks. No improvement. Now Metformin dc'd. How long before the Meformin is out of my system?"
Asked By: cljung  
Category: Kidney Disease

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Expert Answers (1)

09/20/09 05:33 PM

Hello ClJung: Metformin is not metabolized, it remains in your system unchanged and is excreted via the urine. As you know, in kidney disease the use of Metformin in NOT recommended. Technically, It is cleared from the body by the kidney intricate tubular system secretion and excreted unchanged in the urine; metformin is undetectable in blood plasma within 24 hours of a single oral dose. The average elimination half-life in plasma is~ 6.5 hours. Metformin is distributed to (and appears to accumulate in) red blood cells, with a much longer elimination half-life: 17.6 hours, (reported as ranging from 18.5 to 31.5 hours in a single-dose study of non-diabetic people). Considering these studies, I would estimate a conservative estimate of 100-120 hours to total elimination, taking into account kidney function and half-life estimates.

I would encourage continued diligent efforts on maintaining kidney functions. Te progressions of kidney disease go from being overworked, to leaky, to not being able to filter......As the progression goes when filters fail, the waste products accumulate in the blood resulting in potential toxicity. To circumvent this progression the KEY word is "optimize" all the parameters of diabetes control.

  • Glucose levels as close to normal, tight control, this will slow the progression.
  • B(blood)U(urea)N(nitrogen)& Serum Creatinine: 2 blood test that indicate filtering capacity and efficiency, urine creatinine clearance, tell how well the kidneys are getting rid of wastes. The microalbumin/albumin excretion rate identifies whether the kidneys are leaking important life sustantaining nutrients.
  • Keep the blood pressures<130/80mmHG. Possibly the filters are not excreting salt and water efficiently. This extra volume is stressful and can raise the blood pressures and are equally hard on the kidneys. Keep the pressures down, if you are overweight, reduce and limit sodium and proteins. Be your best, regards Sue
    • Answered By: Susan Throop
    Accreditations: RD, CDE, MA
    Sources Show

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