PMID: 8997466Jan 1, 1997Paper

Metformin-associated nonketotic metabolic acidosis

The Annals of Pharmacotherapy
M R JurovichR W Force

Abstract

To document a case of anion gap, nonketotic metabolic acidosis occurring in a patient with acute renal failure who was receiving metformin. A 67-year-old white man presented with a 9-day history of weakness, nausea, dizziness, and difficulty moving; he had also not eaten during the previous 2 days. The patient had numerous abnormalities on his serum chemistry panel and arterial blood gases, including a pH of 7.1 and an anion gap of 21 mEq/L No ketones were detected in the urine. The patient was treated with intravenous fluids, sodium bicarbonate, insulin, and hemodialysis. All medications were discontinued. The acidosis resolved shortly after hemodialysis. The hospital course was complicated by the onset of atrial fibrillation occurring on day 2 that did not respond to chemical cardioversion. On day 6 the patient was discharged home with resolving acute renal failure and normal serum pH. The mortality rate of biguanide-induced lactic acidosis is approximately 50%; thus, early recognition and treatment are essential. Suspicion of lactic acidosis should be high when diabetic patients who are taking a biguanide present with acidosis. The majority of cases of metformin-induced lactic acidosis have occurred in patients with contrain...Continue Reading

References

Nov 1, 1977·Annals of Internal Medicine·R I Misbin
Apr 1, 1992·British Journal of Pharmacology·C J BaileyC Day
Jun 1, 1992·Diabetes Care·C J Bailey
May 1, 1988·Baillière's Clinical Endocrinology and Metabolism·C J Bailey, M Nattrass
May 1, 1987·British Journal of Clinical Pharmacology·A SomogyiF Bochner
Feb 1, 1980·Annals of Internal Medicine·R A Kreisberg
Oct 1, 1994·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·C R Sirtori, C Pasik
Oct 1, 1993·The Annals of Pharmacotherapy·M E McGuinness, R L Talbert
Oct 23, 1993·BMJ : British Medical Journal·I H KhanA M MacLeod
Feb 29, 1996·The New England Journal of Medicine·C J Bailey, R C Turner

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Citations

Oct 3, 2008·Human & Experimental Toxicology·M B Forrester
Apr 29, 1999·Diabetic Medicine : a Journal of the British Diabetic Association·N N ChanM D Feher
Apr 11, 2015·Critical Care Medicine·Diane P CalelloUNKNOWN Extracorporeal Treatments in Poisoning Workgroup
Jan 13, 2001·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·A A AbbasiD G Sotingeanu
Jan 6, 2001·The Annals of Pharmacotherapy·H A SpillerE P Krenzelok
May 6, 2015·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·UNKNOWN Guideline development group
Nov 15, 2019·Physiological Reports·Robert J MerrellsPaul A Fournier
Feb 27, 1999·Journal of Clinical Pharmacy and Therapeutics·W S YapT M Greenaway
Jan 30, 2004·Journal of Internal Medicine·A M E StadesJ B L Hoekstra
Aug 3, 2019·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Isabelle H S KuanDaniel F B Wright
Mar 20, 2004·The Annals of Pharmacotherapy·Henry A Spiller, Debra A Quadrani
Jun 9, 2000·Kidney International·Y Clouâtre

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