Mohsen Akhavan Sepahi
1* 
, Bhaskar VKS Lakkakula
2 , Steven James Kellner
3 , Rohollah Valizadeh
4 1 Department of Pediatric Nephrology, School of Medicine and Pediatric Clinical Research of Development Center, Qom University of Medical Sciences, Qom, Iran
2 Department of Zoology, Guru Ghasidas University, Bilaspur, 495009 (CG), India
3 Head International Research and Development, Mesencell Biotech International Ltd, 20-22 Wenlock Road, London, N1 7GU, United Kingdom
4 Department of Epidemiology, Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
Abstract
There are few publications reporting adverse effects of metformin for patients with type 2 diabetes
mellitus (T2DM) and chronic kidney disease (CKD). Although some of these reports have made big
claims about the adverse effects of metformin in patients with renal failure, the majority of studies
showed a superior safety profile for metformin compared with other antidiabetic medications in
these patients. Further, metformin use is not contributing to an increased incidence of acute kidney
injury (AKI). In conclusion, we suggest that a low dose of metformin is safe to use in patients with
or without CKD. Multicenter randomized trials are required to further discover the benefits of the
risk of metformin therapy in different stages of CKD and its effect on progression of CKD.