The nephrologist's role in metformin-induced lactic acidosis

Nefrologia. 2011;31(5):587-90. doi: 10.3265/Nefrologia.pre2011.Jun.10955.
[Article in English, Spanish]

Abstract

Metformin is an antihyperglycemic agent commonly used in diabetic patients. It is very effective and is able to reduce the plasma glucose and HbA1C. However, in some patients, specially those with comorbidities, metformin can provoke severe lactic acidosis with high morbimortality. Treatment of the lactic acidosis induced by metformin is based on the use of supportive general measures; in severe cases, procedures of extrarrenal purification like hemodialysis or continuous hemodiafiltration have been successfully used.

Publication types

  • Case Reports

MeSH terms

  • Acidosis, Lactic / chemically induced*
  • Acute Kidney Injury / complications
  • Aged
  • Aged, 80 and over
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects
  • Angiotensin-Converting Enzyme Inhibitors / pharmacology
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Cardiovascular Agents / administration & dosage
  • Cardiovascular Agents / adverse effects
  • Cardiovascular Agents / therapeutic use
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / drug therapy
  • Coma / chemically induced
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy
  • Drug Synergism
  • Drug Therapy, Combination
  • Emergencies
  • Fatal Outcome
  • Female
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / adverse effects*
  • Hypoglycemic Agents / therapeutic use
  • Ibuprofen / adverse effects
  • Ibuprofen / pharmacology
  • Ibuprofen / therapeutic use
  • Male
  • Metformin / administration & dosage
  • Metformin / adverse effects*
  • Metformin / therapeutic use
  • Middle Aged
  • Nephrology*
  • Physician's Role*
  • Polypharmacy

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Antidepressive Agents
  • Cardiovascular Agents
  • Hypoglycemic Agents
  • Metformin
  • Ibuprofen