title: [Metformin associates lactic acidosis].
abstract: Metformin Associates lactic acidosis (MALA) is a metabolic acidosis with higher anion gap, high levels of blood lactates and treatment by metformin. MALA is a very rare entity but is associated with high mortality (30 to 50%). The extrarenal blood purification may be necessary in emergency. Relatively good clinical tolerance contrasts with a very elevated serum lactate. There is always a trigger and hypovolemia is prevalent. MALA often occurs when its prescription is not indicated (renal failure, cardiac failure, hypovolemia, or patient aged over 80 years). Metformin must be stopped in situations of acute hypovolemia or frail patients as diuretics or blockers of the rennin-angiotensin-aldosterone system.
authors.affiliation: Assistance publique-Hôpitaux de Paris, hôpital Tenon, urgences néphrologiques et transplantation rénale, 75020 Paris, France. flomontini@yahoo.fr
authors.forename: Florent
authors.initials: F
authors.lastname: Montini
authors.forename: Eric
authors.initials: E
authors.lastname: Rondeau
authors.forename: Julie
authors.initials: J
authors.lastname: Peltier
authors.forename: Laurent
authors.initials: L
authors.lastname: Mesnard
authors.forename: Charlotte
authors.initials: C
authors.lastname: Jouzel
authors.forename: Christophe
authors.initials: C
authors.lastname: Ridel
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects; D008297:Male; D008687:Metformin / Q000009:adverse effects*; D008875:Middle Aged; D008954:Models, Biological; D006435:Renal Dialysis
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin