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

Claire Laforest 1 Franck Saint-Marcoux 1, 2 Jean-Bernard Amiel 1 Nicolas Pichon 3 Louis Merle 1, 4
1 Service de Pharmacologie, toxicologie et pharmacovigilance [CHU Limoges]
2 PIST - Pharmacologie des Immunosuppresseurs et de la Transplantation
3 Service d'Accompagnement et Soins Palliatifs [CHU Limoges]
4 UNILIM - Université de Limoges
Abstract : Metformin 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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Article dans une revue
International Journal of Clinical Pharmacology and Therapeutics, Dustri-Verlag, 2013, 51 (2), pp.147-51. 〈10.5414/CP201728〉
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http://www.hal.inserm.fr/inserm-00925189
Contributeur : Pierre Marquet <>
Soumis le : mardi 7 janvier 2014 - 16:33:44
Dernière modification le : vendredi 16 février 2018 - 15:25:00

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Claire Laforest, Franck Saint-Marcoux, Jean-Bernard Amiel, Nicolas Pichon, Louis Merle. Monitoring of metformin-induced lactic acidosis in a diabetic patient with acute kidney failure and effect of hemodialysis.. International Journal of Clinical Pharmacology and Therapeutics, Dustri-Verlag, 2013, 51 (2), pp.147-51. 〈10.5414/CP201728〉. 〈inserm-00925189〉

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