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Volume 354:1853-1855 April 27, 2006 Number 17
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Preventing Nephropathy Induced by Contrast Medium

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by Barrett, B. J.
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To the Editor: The article by Barrett and Parfrey (Jan. 26 issue)1 raises two clinically relevant points regarding the use of metformin in patients at risk for contrast-medium–induced nephropathy. First, the patient described in the vignette should not have been using metformin, because he already had decreased renal function (estimated glomerular filtration rate, 40 ml per minute per 1.73 m2 of body-surface area), which is a formal contraindication for this medication.2 Second, in patients who do use metformin, the pharmacokinetics of metformin and the clinical course of contrast-medium–induced nephropathy do not support the recommendation of the authors to withhold metformin . . . [Full Text of this Article]



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