Achieving High Dialysis Dose via Continuous Renal Replacement Therapy in the Setting of Metformin Associated Lactic Acidosis. A Case Series.
Journal
A&A practice
ISSN: 2575-3126
Titre abrégé: A A Pract
Pays: United States
ID NLM: 101714112
Informations de publication
Date de publication:
18 Jan 2022
18 Jan 2022
Historique:
entrez:
20
1
2022
pubmed:
21
1
2022
medline:
27
1
2022
Statut:
epublish
Résumé
Severe and life-threatening cases of metformin-associated lactic acidosis (MALA) are treated with renal replacement therapy. Intermittent hemodialysis is recommended, as it achieves rapid more elimination of metformin compared to continuous renal replacement therapy (CRRT). This case series describes 4 patients, 2 with acute metformin intoxications and 2 with insidious metformin toxicity. All were treated using a novel approach with dual CRRT to achieve rapid elimination of metformin. Three of the 4 patients survived to hospital discharge. Dual CRRT may be an effective alternative when dialysis is not readily available.
Identifiants
pubmed: 35050908
doi: 10.1213/XAA.0000000000001561
pii: 02054229-202201000-00007
pmc: PMC8797005
doi:
Substances chimiques
Hypoglycemic Agents
0
Metformin
9100L32L2N
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e01561Informations de copyright
Copyright © 2022 International Anesthesia Research Society.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
DeFronzo R, Fleming GA, Chen K, Bicsak TA. Metformin-associated lactic acidosis: Current perspectives on causes and risk. Metabolism. 2016;65:20–29.
Yeh HC, Ting IW, Tsai CW, Wu JY, Kuo CC. Serum lactate level and mortality in metformin-associated lactic acidosis requiring renal replacement therapy: a systematic review of case reports and case series. BMC Nephrol. 2017;18:229.
Boucaud-Maitre D, Ropers J, Porokhov B, et al. Lactic acidosis: relationship between metformin levels, lactate concentration and mortality. Diabet Med. 2016;33:1536–1543.
Lalau JD, Westeel PF, Debussche X, et al. Bicarbonate haemodialysis: an adequate treatment for lactic acidosis in diabetics treated by metformin. Intensive Care Med. 1987;13:383–387.
Rifkin SI, McFarren C, Juvvadi R, Weinstein SS. Prolonged hemodialysis for severe metformin intoxication. Ren Fail. 2011;33:459–461.
Greco P, Regolisti G, Maggiore U, et al. Sustained low-efficiency dialysis for metformin-associated lactic acidosis in patients with acute kidney injury. J Nephrol. 2019;32:297–306.
Angioi A, Cabiddu G, Conti M, et al. Metformin associated lactic acidosis: a case series of 28 patients treated with sustained low-efficiency dialysis (SLED) and long-term follow-up. BMC Nephrol. 2018;19:77.
Friesecke S, Abel P, Kraft M, Gerner A, Runge S. Combined renal replacement therapy for severe metformin-induced lactic acidosis. Nephrol Dial Transplant. 2006;21:2038–2039.
Panzer U, Kluge S, Kreymann G, Wolf G. Combination of intermittent haemodialysis and high-volume continuous haemofiltration for the treatment of severe metformin-induced lactic acidosis. Nephrol Dial Transplant. 2006;19:21572158.
Lalau JD, Kajbaf F, Protti A, Christensen MM, De Broe ME, Wiernsperger N. Metformin-associated lactic acidosis (MALA): moving towards a new paradigm. Diabetes Obes Metab. 2017;19:1502–1512.
Lalau J-D, Lacroix CCB, De Cagny B, Fournier A. Metformin-associated lactic acidosis in diabetic patients with acute renal failure: a critical analysis of its pathogenesis and prognosis. Nephrol Dial Transplant. 1994;9(suppl 4):126129.
Calello DP, Liu KD, Wiegand TJ, ; Extracorporeal Treatments in Poisoning Workgroup. Extracorporeal treatment for metformin poisoning: systematic review and recommendations from the Extracorporeal Treatments in Poisoning Workgroup. Crit Care Med. 2015;43:1716–1730.
Ricci Z, Ronco C, D’Amico G, et al. Practice patterns in the management of acute renal failure in the critically ill patient: an international survey. Nephrol Dial Transplant. 2006;21:690–696.
Mariano F, Pozzato M, Inguaggiato P, et al. Metformin-associated lactic acidosis undergoing renal replacement therapy in intensive care units: A Five-Million Population-Based Study in the North-West of Italy. Blood Purif. 2017;44:198–205.