• Int J Clin Pharm Th · Feb 2013

    Case Reports

    Monitoring of metformin-induced lactic acidosis in a diabetic patient with acute kidney failure and effect of hemodialysis.

    • Claire Laforest, Franck Saint-Marcoux, Jean-Bernard Amiel, Nicolas Pichon, and Louis Merle.
    • Department of Pharmacology-Toxicology-Pharmacovigilance, Dupuytren Hospital, Limoges, France.
    • Int J Clin Pharm Th. 2013 Feb 1; 51 (2): 147-51.

    AbstractMetformin associated lactic acidosis (MALA) is a serious complication occurring especially in elderly patients given high doses of the drug. We report a non-fatal case of MALA with pronounced acidosis (pH 6.76, lactate 30.81 mmol/l) and high metformin concentrations (127 mg/l) in a patient who had developed acute renal failure after undergoing an operation. Multiple measurements of biological parameters and metformin blood concentrations showed the effectiveness of repeated hemodialysis sessions on metformin elimination. Cases previously reported with such a severe MALA were associated with a high mortality rate. We show that close monitoring in an intensive care unit together with prompt and repeated dialysis sessions can lead to a favorable outcome.

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