Metformin-associated lactic acidosis precipitated by diarrhea.
Metformin-associated lactic acidosis (MALA) is a serious metabolic complication that occurs because of metformin accumulation in patients who become dehydrated or developed acute renal failure. Bicarbonate hemodialysis treatment should take place early in the course of management, especially in patients with severe metabolic acidosis who fail to respond to intravenous bicarbonate therapy or in whom renal failure is present. We report a case of MALA in which acute renal failure resulting from dehydration secondary to diarrhea and poor oral intake likely caused MALA. Early recognition of this condition and initiation of effective treatment can improve outcome.
Nephrology and Dialysis Center, Renal Division, Coney Island Hospital, Brooklyn, NY, USA. goodkidneys@aol.com
Adel S
AS
El-Hennawy
Sunitha
S
Jacob
Aza K
AK
Mahmood
D000140:Acidosis, Lactic / Q000139:chemically induced* / Q000628:therapy; D058186:Acute Kidney Injury / Q000150:complications; D003681:Dehydration / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D003967:Diarrhea / Q000150:complications*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008687:Metformin / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D006435:Renal Dialysis
D007004:Hypoglycemic Agents; D008687:Metformin