PMID: 11910877Mar 26, 2002Paper

Metformin-associated lactic acidosis with acute renal failure in type 2 diabetes mellitus

Medizinische Klinik
Beate BernerGerhard A Müller

Abstract

An 83-year-old patient was admitted to our hospital because of gastrointestinal symptoms, mental confusion and dysarthria. The patient suffered from type 2 diabetes mellitus and was taking metformin. A mild renal insufficiency was known. On admission, we found impaired consciousness, Kussmaul breathing, a body temperature of 32.1 degrees C, and hemodynamic instability. Laboratory testing revealed lactic acidosis (pH 6.71, base excess--30, standard bicarbonate 4.0 mmol/l, lactate 24.4 mmol/l) and acute renal failure with a creatinine of 10.6 mg/dl and blood urea nitrogen of 134 mg/dl. Electrolytes were not altered; the blood glucose was elevated (147 mg/dl). According to history, physical examination, and laboratory testing the diagnosis metformin-induced lactic acidosis with acute renal failure was made. This diagnosis was confirmed by an elevated level of metformin. As soon as possible a bicarbonate hemodialysis was initiated. After 8 hours of hemodialysis the acid-base metabolism was almost balanced and the vigilance of the patient normalized. No further sessions of hemodialysis were needed and insulin therapy was started. Metformin-induced lactic acidosis is a common side effect in patients with renal insufficiency. For an e...Continue Reading

Citations

Nov 13, 2002·Pharmacoepidemiology and Drug Safety
Feb 27, 2004·Diabetic Medicine : a Journal of the British Diabetic Association·T VanderY O Herishanu
May 6, 2015·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·UNKNOWN Guideline development group
May 26, 2007·Journal of Forensic Sciences·Veniero GambaroElisa Saligari
Apr 11, 2015·Critical Care Medicine·Diane P CalelloUNKNOWN Extracorporeal Treatments in Poisoning Workgroup

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