Authors: F. Musil 1; A. Šmahelová 1; J. Zajíc 1; Maňák J. Mádlová E. 1 2; L. Sobotka 1 Authors‘ workplace: Klinika gerontologická a metabolická Fakultní nemocnice Hradec Králové Přednosta: prof. MUDr. L. Sobotka, CSc. 1; Interní oddělení Nemocnice Nový Bydžov Primář: MUDr. J. Drugda 2 Published in: Prakt. Lék. 2006; 86(12): 707-709 Category: Case Report
Lactic acidosis is a known adverse risk of metformin treatment. Here we have outlined a case in which lactic acidosis developed during treatment of a diabetic patient in whom there were no contraindications to metformin treatment. Lactic acidosis was caused by acute renal failure leading to metformin accumulation. The acute renal failure was caused by a combination of dehydration due to a low intake of fluids when disabled because of a fractured ankle, concomitant diuretic treatment of arterial hypertension and angiotensin-converting enzyme inhibitor treatment. The patient was successfully treated by a combination of haemodialysis and infusion therapy. We recommend that all patients on metformin should consider temporarily discontinuing treatment in the event of severe illness, including dehydration.
Key words: lactic acidosis, metformin, renal failure, type 2 diabetes
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