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Severe lactic acidosis associated with acute renal failure in a diabetic patient treated with metformin – A case study.


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

Overview

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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