[Metformin and kidneys]

Metformin is currently recommended as the first-line drug for type 2 diabetic patients once the disease has been diagnosed. In addition to antihyperglycaemic effect, it has other effects which have a positive effect on cardiovascular risk. The greatest risk of metformin treatment is lactate acidosis, but its incidence is very low if the contraindications are observed. In spite of the fact that not all contraindications are observed in practice, the incidence of lactate acidosis demonstrably provoked by metformin does not grow. In spite of ongoing discussion on the subject, contraindications still include all states involving the risk of lactacidosis including renal insufficiency.