Metformin is the primary anti-diabetic drug in type-2 diabetes.However, controversy exists on its use in patients with renal impairment.Here we investigated the acute metabolic effects of metformin treatment in rat kidneys,with hyperpolarized 13Cpyruvate and Clark-electrodes.A significantly altered metabolic phenotype was observed 30min post metformin treatment.Anaerobic metabolism was elevated in the cytosol,indicated by increased lactate/pyruvate ratio,and mitochondrial aerobic metabolism was reduced,indicated by decreased bicarbonate/pyruvate ratio.Acute metformin treatment increased renal blood flow with higher O2 saturation and did not change tubular O2 consumption.These results indicate that metformin reduces mitochondrial respiration and enhances anaerobic metabolism,even with enough oxygen supply,within only 30min of treatment.
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