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Comment & Response
March 2019

Inconsistencies in Reporting Studies of Lactic Acidosis

Author Affiliations
  • 1Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
JAMA Intern Med. 2019;179(3):455-456. doi:10.1001/jamainternmed.2018.8627

To the Editor In their recently published Original Investigation regarding metformin use, renal function, and acidosis, Lazarus and colleagues1 explained why their findings were different than ours2 and wrote that our study “was limited by sparse [estimated glomerular filtration rate] data and did not account for changes in [estimated glomerular filtration rate] over time.”1(909) This is not true. Table 2 in our article2 summarized that we were able to classify more than 90% of metformin exposure time to renal function. In addition, our methods section clearly stated that we determined renal function during follow-up time and ran our analysis using a time-varying Cox regression analysis in which we modeled both changes in metformin exposure and changes in renal function over calendar time.

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