• Presse Med · Oct 2012

    Review Case Reports

    [Metformin associates lactic acidosis].

    • Florent Montini, Eric Rondeau, Julie Peltier, Laurent Mesnard, Charlotte Jouzel, and Christophe Ridel.
    • Assistance publique-Hôpitaux de Paris, hôpital Tenon, urgences néphrologiques et transplantation rénale, 75020 Paris, France. flomontini@yahoo.fr
    • Presse Med. 2012 Oct 1; 41 (10): 907-16.

    AbstractMetformin 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.Copyright © 2012 Elsevier Masson SAS. All rights reserved.

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