title: The nephrologist's role in metformin-induced lactic acidosis.
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.
authors.affiliation: Nephrology Department, University Hospital of Guadalajara, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Gómez-Navarro
authors.forename: G
authors.initials: G
authors.lastname: de Arriba
authors.forename: M
authors.initials: M
authors.lastname: Sánchez-Heras
authors.forename: K M
authors.initials: KM
authors.lastname: Pérez del Valle
authors.forename: B
authors.initials: B
authors.lastname: Hernández-Sevillano
authors.forename: M A
authors.initials: MA
authors.lastname: Basterrechea
authors.forename: S
authors.initials: S
authors.lastname: Tallón
authors.forename: M
authors.initials: M
authors.lastname: Torres-Guinea
authors.forename: J R
authors.initials: JR
authors.lastname: Rodríguez-Palomares
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced*; D058186:Acute Kidney Injury / Q000150:complications; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy; D003128:Coma / Q000139:chemically induced; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D004630:Emergencies; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D007052:Ibuprofen / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008687:Metformin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D009398:Nephrology; D010819:Physician's Role; D019338:Polypharmacy
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000928:Antidepressive Agents; D002317:Cardiovascular Agents; D007004:Hypoglycemic Agents; D008687:Metformin; D007052:Ibuprofen