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The interconversion between thiols and disulfide groups is a redox reaction: the thiol is the reduced state, and the disulfide is the oxidized state

doi: 10.1186/1477-7819-12-164 126 NguyenTTLianSUngTTXiaYHanJYDo JungY

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Muoz S.J.L

To address this, the FDA updated its guidelines in 2016, allowing metformin use in patients with mild to moderate kidney impairment but advising against its use in those with severe kidney disease (eGFR below 30 mL/min/1.73 m)