title: Metformin-associated acute kidney injury and lactic acidosis.
abstract: Objectives. Metformin is the preferred oral antidiabetic agent for type 2 diabetes. Lactic acidosis is described as a rare complication, usually during an acute kidney injury (AKI). Material and Methods. We conducted a prospective observational study of metformin-associated AKI cases during four years. 29 cases were identified. Previous renal function, clinical data, and outcomes were recorded. Results. An episode of acute gastroenteritis precipitated the event in 26 cases. Three developed a septic shock. Three patients died, the only related factor being liver dysfunction. More severe metabolic acidosis hyperkalemia and anemia were associated with higher probabilities of RRT requirement. We could not find any relationship between previous renal dysfunction and the outcome of the AKI. Conclusions. AKI associated to an episode of volume depletion due to gastrointestinal losses is a serious complication in type 2 diabetic patients on metformin. Previous renal dysfunction (mild-to-moderate CKD) has no influence on the severity or outcome.
authors.affiliation: Nephrology Department, Hospital General Universitario Gregorio Marañón, Street Dr. Esquerdo 46, 28007 Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Arroyo
authors.forename: Rosa
authors.initials: R
authors.lastname: Melero
authors.forename: Nayara
authors.initials: N
authors.lastname: Panizo
authors.forename: Marian
authors.initials: M
authors.lastname: Goicoechea
authors.forename: Patrocinio
authors.initials: P
authors.lastname: Rodríguez-Benítez
authors.forename: Soledad García
authors.initials: SG
authors.lastname: Vinuesa
authors.forename: Eduardo
authors.initials: E
authors.lastname: Verde
authors.forename: Alberto
authors.initials: A
authors.lastname: Tejedor
authors.forename: José
authors.initials: J
authors.lastname: Luño